| 覆膜支架在颅颈血管病变治疗中的应用 |
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| 引用本文： | 韩登峰,孔祥锋,吐尔逊•沙比尔. 覆膜支架在颅颈血管病变治疗中的应用[J]. 中国组织工程研究, 2011, 15(21): 3957-3960. DOI: 10.3969/j.issn.1673-8225.2011.21.037 |
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| 作者姓名： | 韩登峰 孔祥锋 吐尔逊•沙比尔 |
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| 作者单位： | 1新疆医科大学第一附属医院神经内科,新疆维吾尔自治区乌鲁木齐市8300002新疆医科大学第五附属医院神经内科,新疆维吾尔自治区乌鲁木齐市830011 |
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| 摘 要： | 背景：随着微导管技术的不断完善和栓塞材料的改进,血管内介入治疗已成为治疗颅颈血管病变的首选方法,主要包括可脱球囊、弹簧圈、液体栓塞剂、覆膜支架。与其他血管内栓塞治疗技术相比,覆膜支架有2个突出优点：有较高的完全闭塞率和较低的再通率。目的：介绍国内主要应用的几种覆膜支架,以及覆膜支架治疗颅颈动脉瘤和颈内动脉海绵窦瘘的临床效果。方法：以“覆膜支架,生物相容性,动脉瘤,颈动脉海绵窦瘘”为关键词,采用计算机检索万方数据网1998-01/2010-12相关文章。纳入覆膜支架治疗颅颈血管病变方面的文献,排除重复研究或Mata分析类文章。结果与结论：现在神经外科临床应用的覆膜支架,主要采用的是美国Abbott公司推出的Jostent覆膜支架和上海微创公司生产的Willis覆膜支架。Jostent覆膜支架优点是生物相容性和扩展性较好,其多微孔结构可减少细胞扩散,阻止血小板聚集、炎性细胞移动,从而降低了继发性血栓及血管狭窄的概率;其缺点是在颅内动脉中应用的范围比较狭窄,动脉不能过于迂曲,弯曲角度不能过于锐利,病变附近不能有不可闭塞的穿支或分支。专为颅内血管设计的Willis覆膜支架的应用,彻底改变了颅内动脉瘤血管内治疗的传统理念,整个支架系统具有一定的柔顺性,有助于其通过颅内弯曲的血管系统,尤其是颈内动脉虹吸段,由于其操作简单,效果满意,为血管内治疗技术的发展提供了新的方向。
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| 关 键 词： | 覆膜支架 生物相容性 动脉瘤 颈动脉海绵窦瘘 血管病变 组织工程 |
| 收稿时间： | 2011-01-31 |
Covered stents for craniocervical vascular diseases |
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| Han Deng-feng,Kong Xiang-feng,Tuerxun•Shabier. Covered stents for craniocervical vascular diseases[J]. Chinese Journal of Tissue Engineering Research, 2011, 15(21): 3957-3960. DOI: 10.3969/j.issn.1673-8225.2011.21.037 |
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| Authors: | Han Deng-feng Kong Xiang-feng Tuerxun•Shabier |
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| Affiliation: | 1Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
2Department of Neurology, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China |
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| Abstract: | BACKGROUND:Endovascular treatment has become the preferred choice for craniocervical vascular diseases, including detachable balloons, coils, liquid embolic agent, and covered stent. The covered stent has two advantages: a higher rate of complete occlusion and lower recanalization rate.OBJECTIVE:To introduce several kinds of covered stents in China and to investigate the curative effects of covered stents on craniocervical artery aneurysms and carotid cavernous fistula.METHODS:A computer based search of Wanfang database was performed for relevant articles published between 1998-01 and 2010-12 using the keywords of “covered stent, biocompatibility, aneurysms, carotid cavernous fistula”. Repetitive articles and Meta analysis were excluded.RESULT S AND CONCLUSION: Jostent stent produced by Abbott, USA, and Willis stent produced by Shanghai Mini-invasive Company are commonly used in clinical neurosurgery. Jostent stent has a good biocompatibility and expansibility, and its porous structure can reduce cell spreading, and prevent platelet aggregation and inflammatory cell migration so as to reduce the probability of secondary thrombosis and vascular stenosis. However, the disadvantages of Jostent stent are limitations used in intracranial arteries: the bending angles of the artery cannot be very sharp, and non-occlusive perforating arteries and branches cannot exist around the lesion. Willis stent that completely changes the traditional concept about endovascular treatment of intracranial aneurysms has certain flexibility in the entire stent system which contributes to the intracranial vascular system, in particular, the siphon segment of carotid artery. Because of its simple operation and satisfactory effects, Willis stent offers a new direction for endovascular therapy development. |
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