球囊联合支架辅助弹簧圈栓塞颅内分叉部宽颈动脉瘤

目的：分析球囊联合支架辅助弹簧圈栓塞术治疗颅内分叉部宽颈动脉瘤的优势。方法回顾性分析2014年1月至4月昆明医科大学第一附属医院采用球囊联合支架辅助弹簧圈栓塞术治疗20例共25枚颅内分叉部宽颈动脉瘤患者的临床资料。20例患者中曾患蛛网膜下腔出血12例,无出血史8例;25枚颅内分叉部宽颈动脉瘤中位于基部动脉未端分叉部14枚,大脑中动脉分叉部8枚,颈内动脉末端分叉部3枚。根据Raymond分级评价介入治疗术后即刻和3个月后三维DSA检查结果,根据改良Rankin 量表（mRS）评分评价术后3个月临床疗效。结果球囊联合支架辅助弹簧圈栓塞术后即刻三维DSA检查显示25枚颅内分叉部宽颈动脉瘤中RaymondⅠ级21枚,Ⅱ级2枚,Ⅲ级2枚;术后3个月DSA随访显示RaymondⅠ级20枚,Ⅱ级3枚,Ⅲ级2枚。术后3个月mRS评分显示17例患者0分,1例患者1分,均预后良好;2例患者4～6分,预后不良。结论球囊联合支架辅助弹簧圈栓塞术在颅内分叉部宽颈动脉瘤介入治疗术中具有明显优势。     

难治性颅内动脉瘤血管内支架治疗的初步结果

目的　总结血管内支架结合电解可脱卸弹簧圈 (GDC)治疗分叉部宽颈动脉瘤及复发动脉瘤的技术及疗效。方法　采用血管内支架结合GDC治疗 5例颅内动脉瘤 ,其中颈内动脉分叉部动脉瘤2例 ,基底动脉宽颈瘤 1例和后交通宽颈动脉瘤复发 2例。 3例支架跨重要侧支血管及穿动脉放置。通过支架上的网孔将微导管送入动脉瘤腔 ,继续GDC填塞。结果　 4例动脉瘤达到致密填塞 ,1例大部填塞 ,载瘤动脉及侧支血管通畅 ,1例术后出现动眼神经麻痹 ,3个月后恢复。影像学随访 3～ 6个月 ,无支架内狭窄。结论　联合使用支架及GDC是治疗分叉部宽颈动脉瘤及复发动脉瘤的有效方法 ,临床应用前景广阔。支架覆盖重要动脉开口并不影响血流。     

Neuroform自膨式支架结合弹簧圈栓塞颅内宽颈动脉瘤

目的 探讨Neuroform自膨式支架结合弹簧圈治疗颅内宽颈动脉瘤的安全性、术中并发症、近中期疗效和应用前景.方法 采用Neuroform支架结合弹簧圈栓塞治疗25例27枚颅内宽颈动脉瘤.动脉瘤位于颈内动脉海绵窦段3枚,眼动脉1枚,后交通动脉18枚,前交通动脉2枚,大脑中动脉M1段1枚,大脑中动脉分义部1枚,基底动脉干1枚.其巾2例患者为多发动脉瘤,绝对宽颈(瘤颈>4 mm)动脉瘤21枚,相对宽颈6枚,瘤颈/瘤体均大于0.7.结果 4枚采用NeuroformⅡ代自膨式支架结合弹簧圈栓塞治疗,其余均采用NeuroformⅢ代支架结合弹簧罔栓塞治疗.25例26枚支架均成功到位释放,1例多发动脉瘤患者置入2枚支架.7枚动脉瘤完全栓塞(100%),9枚几乎完全栓寒(95%～99%),11枚不完全栓塞(95%以下).2例术中出血;2例术中支架内血栓形成,其中1例术后遗留肢体偏瘫,另1例死亡;1例术中弹簧圈尾端从支架网孔突入颈内动脉,术后出现一过性脑缺血表现,其余患者均恢复良好出院.临床随访24例,随访期1～32个月,平均10.8个月.3例术后3～6个月血管造影随访,其中1例后交通动脉瘤患者同侧大脑前动脉闭塞,大脑中动脉主干血栓形成;另2例原有瘤颈残留者无变化.结论 在栓塞颅内宽颈动脉瘤时应用Neurolform自膨式支架结合弹簧圈技术,使弹簧圈无法突入载瘤动脉,可提高柃塞致密度,安全、疗效好.     

Neuroform支架辅助弹簧圈填塞治疗颅内宽颈动脉瘤

目的 探讨 Neuroform支架辅助弹簧圈填塞治疗颅内宽颈动脉瘤的技术,并评价临床疗效和并发症.方法 采用Neuroform支架辅助技术对31例颅内宽颈动脉瘤进行了弹簧圈填塞治疗.31例患者共有颅内动脉瘤43枚,均为破裂动脉瘤,其中39枚为宽颈动脉瘤,21枚颈:体≥1,18枚颈:体<1;4枚为宽颈动脉瘤患者合并的非宽颈动脉瘤.结果 31例患者共置入支架35枚,其中3例患者两侧颈内动脉各置入1枚支架,1例两侧大脑中动脉各置入1枚.43枚动脉瘤中41枚进行了不同程度的填塞,2枚末行填塞.2例宽颈动脉瘤患者置入支架后出现非动脉瘤破裂性出血,均可能由于输送导丝损伤大脑中动脉分支引起;1例后交通动脉瘤患者,弹簧圈飘至大脑中动脉M2段,引起相应脑缺血症状.获随访的29例中无死亡病例和再次出血病例,28例生存良好,1例留有明显神经功能障碍.结论 支架辅助技术进行弹簧圈填塞治疗颅内宽颈动脉瘤是安全、有效的临床技术,可以拓宽颅内动脉瘤治疗的适应证.     

颅内自膨胀支架结合弹簧圈治疗脑动脉瘤

目的　报道采用自膨胀颅内专用支架 (Neuroform支架 )结合弹簧圈栓塞治疗颅内宽颈动脉瘤 ,初步探讨该支架的特点、短期疗效及应用前景。方法　采用Neuroform支架结合弹簧圈栓塞治疗 32例 34枚颅内宽颈动脉瘤。颈内动脉海绵窦段 3例 ,眼动脉 3例 ,后交通动脉 8例 ,前交通动脉 3例 ,大脑中动脉分叉部 5例 ,椎动脉 6例 ,基底动脉顶端 1例 ,基底动脉干 2例 ,大脑前动脉A3段 1例 ,多发动脉瘤 2例。通过Renegade微导管释放Neuroform支架覆盖动脉瘤瘤颈 ,预先将另一微导管置入动脉瘤腔或将微导管通过支架网孔以弹簧圈栓塞动脉瘤。结果　 31例 34个支架成功到位释放 ,1例基底动脉顶端动脉瘤因支架无法通过狭窄的大脑后动脉而改用BX支架。 3例 1次各置入 2枚支架。 2 4例致密栓塞 ,6例瘤颈残留 ,2例部分栓塞。 1例术中发生支架内血栓 ,死亡 1例 ,其余患者均恢复良好出院。临床随访 30例 ,随访期 1～ 6个月 ,平均 4 .7个月 ,无再出血及血栓栓塞症状发生。 1 1例术后 3个月血管造影随访 :7例致密栓塞的动脉瘤均未显影 ;4例瘤颈残留者 ,2例无变化 ;2例原有瘤颈残留未再显影。结论　Neuroform支架技术上容易操控 ,顺应性好 ,安全性高 ,可以到达颅内较远端的血管 ,大大扩展了支架技术治疗颅内血管病变的应用范围 ,近期     

Solitaire AB支架在辅助栓塞颅内宽颈动脉瘤中的临床应用

目的评价Solitaire AB支架在辅助栓塞颅内宽颈动脉瘤中的临床应用价值。方法应用Solitaire AB支架治疗颅内宽颈动脉瘤25例,其中后交通动脉瘤15枚,眼动脉段动脉瘤4枚,颈内动脉海绵窦段动脉瘤1枚,大脑中动脉瘤1枚,椎动脉动脉瘤4枚。结果 25例中,完全栓塞22例,瘤颈残留1例,部分栓塞2例。术中动脉瘤破裂1例,术后脑积水行脑脊液分流术1例,弹簧圈移位1例。随访未有再出血病例。造影随访12例,复发1例。结论应用Solitaire AB支架在辅助栓塞颅内宽颈动脉瘤具有较高的临床价值,值得临床推广。     

单纯支架治疗颅内宽颈囊性小动脉瘤的临床疗效分析

目的 探讨和总结单纯支架植入治疗颅内宽颈囊性小动脉瘤的可行性、安全性和疗效.方法 2001年2月到2009年11月,采用单纯支架植入法治疗36例颅内宽颈囊性小动脉瘤.按临床Hunt ＆ Hess分级,0级22例,Ⅰ级8例,Ⅱ级5例,Ⅲ级1例.动脉瘤直径为1.8 ～ 5.0 mm,平均3.6 mm.分别位于基底动脉(1例)、前交通动脉(1例)、后交通动脉(11例)、颈内动脉床突上段(18例)、脉络膜前动脉(4例)和大脑中动脉(1例).采用DSA或MRA及改良MRS(modified rankin scale)评分进行影像和临床随访.结果 36例颅内宽颈囊性小动脉瘤患者共成功植入37枚支架.术后即刻造影显示1例动脉瘤完全不显影,2例血管迂曲度明显改变,3例明显对比剂滞留.对22例患者进行了影像学随访,其中20例采用DSA造影,2例采用增强MRA,平均随访时间为16个月(3 ～ 59个月).动脉瘤完全愈合11例(50%),动脉瘤颈变窄伴动脉瘤体缩小9例(40%),单纯动脉瘤颈变窄1例(5%),单纯动脉瘤体缩小1例(5%).临床随访除1例失访外,其余35例均无病情恶化或遗留永久神经功能缺失.术中、术后并发症有短暂脑缺血发作1例,血管痉挛3例,股动脉穿刺点血肿1例,颅内感染1例.结论 对于传统血管内介入和开颅夹闭存在一定困难的颅内宽颈囊性小动脉瘤,单纯支架植入术是可供选择的治疗方法之一.近期疗效满意,远期疗效、安全性和疗效仍需大宗病例的验证.     

支架技术在颅内复杂动脉瘤治疗中的应用

目的探讨支架在颅内复杂动脉瘤中的治疗技术及应用价值。方法回顾性分析应用支架技术辅助栓塞治疗的31例颅内动脉瘤患者（宽颈动脉瘤28例,梭形动脉瘤3例）的临床资料。术中将支架引至动脉瘤处释放支架覆盖动脉瘤颈,并结合弹簧圈栓塞术。结果 31例共置入支架32枚,其中Enterprise支架24枚,LEO支架5枚,Solitaire AB支架3枚。采用单纯支架置入技术2例,此2例微小动脉瘤术后见瘤腔内造影剂滞留。支架结合弹簧圈治疗29例,其中支架先释放技术7例,支架后释放技术22例,支架结合弹簧圈治疗组取得满意疗效。术后即刻栓塞结果按改良的Raymond分级：动脉瘤体完全栓塞20例（Ⅰ级）,瘤颈残留7例（Ⅱ级）,瘤体显影2例（Ⅲ级）。随访1～6个月未发生再出血及缺血并发症。结论支架辅助栓塞技术是治疗颅内动脉瘤安全有效的方法,可提高动脉瘤栓塞的致密程度,采用支架后释放技术使绝大多数颅内复杂动脉瘤的介入治疗成为可能。     

颅内覆膜支架治疗颅段颈内动脉病变的初步临床研究

目的观察采用颅内专用覆膜支架及其输送系统通过颅段颈内动脉（CICA）骨性管道和生理弯曲，治疗颅段颈内动脉病变的效果。方法采用颅内专用覆膜支架，以血管内技术治疗13例CICA病变。其中巨大假性动脉瘤4例、巨大动脉瘤4例、宽颈小动脉瘤3例、巨大假性动脉瘤伴颈动脉海绵窦瘘（CCF）1例、CCF1例。颅内专用覆膜支架释放前均行患侧颈内动脉球囊闭塞试验（BOT）和DSA。术后3～16个月施行DSA随访和临床随访。结果13例患者BOT均耐受良好，DSA证实前、后交通动脉开放良好。13例覆膜支架及其输送系统均顺利通过CICA到达病变靶区。病变及覆膜支架释放部位分别为：C3～4段4例、C4～5段4例、C6～7段5例。覆膜支架释放后即刻DSA示7例动脉瘤不再显影，4例显示少量内漏，1例CCF覆膜支架释放后流量明显减少，1例假性动脉瘤伴CCF覆膜支架释放后动脉瘤消失，但残存低流量CCF。13例中1例动脉瘤破裂性蛛网膜下腔出血患者术后9d因血管广泛痉挛而死亡。12例随访DSA均显示覆膜支架放置处血管通畅，其中2例显示轻度狭窄；6例术后存在内漏，其中4例DSA随访7～16个月后内漏消失，1例再次置入覆膜支架治疗后内漏消失；1例CCF，3个月后随访仍显示低流量瘘。存活患者临床随访3～16个月未发生支架覆盖段相关分支堵塞后的并发症。结论颅内覆膜支架及其输送系统的柔顺性足以使其通过迂曲的CICA，到达颅内病变血管处，有效治疗CICA病变。颅内覆膜支架的远期疗效有待长期随访，其贴壁性能仍需进一步完善。     

血管内支架结合弹簧圈治疗颅内宽颈动脉瘤的影像学随访结果

目的 总结血管内支架结合弹簧圈治疗颅内宽颈动脉瘤的影像学随访结果，了解支架技术在脑动脉瘤治疗中的作用。方法 62例颅内宽颈动脉瘤患者接受血管内支架结合弹簧圈栓塞治疗，并在术后行脑血管造影及临床随访。结果 所有患者均成功植入支架，47例动脉瘤达到致密填塞，15例大部填塞，载瘤动脉通畅。1～6个月造影随访56例动脉瘤内无造影剂显影，4例仍有瘤颈残留，1例复发而再次治疗；12～37个月随访43例中，2例瘤颈残余，1例动脉瘤复发，其余完全闭塞，弹簧圈形态无改变。结论 血管内支架植入后明显改变瘤内血流动力学并促进血栓形成，通过促进瘤颈内膜形成达到影像学治愈。     

Endovascular treatment of a giant intracranial aneurysm with a stent-graft

This report describes a giant intracavernous carotid aneurysm successfully treated by the placement of a single covered stent. A 40-year-old woman was admitted with a progressive diplopia in relation with palsy of the IV and VI cranial nerves. Magnetic resonance imaging revealed an intracavernous giant aneurysm located at the bifurcation between the origin of a trigeminal artery and the intracavernous portion of the right internal carotid artery. A covered stent was successfully placed, and complete exclusion of the aneurysm was confirmed at 11-month follow-up angiography. The use of covered stents in intracranial vascular structures can now be a feasible way of treating selected cases of wide-necked intracranial aneurysms.     

Late angiographic and clinical follow-up results of 100 consecutive aneurysms treated with Onyx reconstruction: largest single-center experience

We present the long-term clinical and angiographic follow-up results of 100 consecutive intracranial aneurysms treated with Onyx liquid embolic system (MTI, Irvine, Calif.), either alone or combined with an adjunctive stent, in a single center. A total of 100 aneurysms in 94 patients were treated with endosaccular Onyx packing. Intracranial stenting was used adjunctively in 25 aneurysms including 19 during initial treatment and 6 during retreatment. All aneurysms except two were located in the internal carotid artery. Of the 100 aneurysms, 35 were giant or large/wide-necked, and 65 were small. Follow-up angiography was performed in all 91 surviving patients (96 aneurysms) at 3 and/or 6 months. Follow-up angiography was performed at 1, 2, 3, 4 and 5 years in 90, 41, 26, 6 and 2 patients, respectively. Overall, aneurysm recanalization was observed in 12 of 96 aneurysms with follow-up angiography (12.5%). All 12 were large or giant aneurysms, resulting in a 36% recanalization rate in the large and giant aneurysm group. One aneurysm out of 25 treated with the combination of a stent and Onyx showed recanalization. There was also no recanalization in the follow-up of small internal carotid artery aneurysms treated with balloon assistance only. At final follow-up, procedure- or device-related permanent neurological morbidity was present in eight patients (8.3%). There were two procedure-related and one disease-related (subarachnoid hemorrhage) deaths (mortality 3.2%). Delayed spontaneous asymptomatic occlusion of the parent vessel occurred in two patients, detected on routine follow-up. Onyx provides durable aneurysm occlusion with parent artery reconstruction resulting in perfectly stable 1-year to 5-year follow-up angiography both in small aneurysms treated with balloon assistance only (0% recanalization rate) and large or giant aneurysms treated with stent and Onyx combination (4% recanalization rate). Endosaccular Onyx packing with balloon assistance may not be adequate for stable long-term results in those with a large or giant aneurysm. However, the recanalization rate of 36% in these aneurysms is better than the reported results with other techniques, i.e., coils with or without adjunctive bare stents.     

Treatment of wide-necked intracranial aneurysms with a self-expanding stent system: initial clinical experience

BACKGROUND AND PURPOSE: Currently available stents for intracranial use usually are balloon-expandable coronary stents that carry the risk of damaging a dysplastic segment of the artery, with potential vessel rupture. We assessed the technical feasibility and efficacy of the combined application of a flexible, self-expanding neurovascular stent and detachable coils in the management of wide-necked intracranial aneurysms in humans. METHODS: Four consecutive patients with a wide-necked intracranial aneurysm were treated with a combined approach that consisted of delivery of a flexible self-expanding neurovascular stent through a microcather to cover the neck of the aneurysm and subsequent filling of the aneurysm with coils through the stent interstices. The aneurysms were located at the internal carotid artery (n=2) and the basilar tip encroaching the P1 segment (n=2). Previous attempts with conventional endosaccular coil packing alone failed in all cases. RESULTS: Stent placement in the desired position with complete or nearly complete occlusion of the aneurysms was feasible in all patients. In one patient, aneurysm perforation with the microcatheter occurred and necessitated ventricular drainage, which led to a large parenchymal and intraventricular hemorrhage because of the strong anticoagulation regimen. Six-month follow-up demonstrated no focal neurologic sequelae in any of the patients, except slight memory dysfunction in the patient with bleeding. CONCLUSION: Preliminary data demonstrate that this extremely flexible stent is technically easy to deploy and can be easily and safely maneuvered through severely tortuous vessels, enabling the treatment of intracranial wide-necked aneurysms. The combination of endovascular reconstruction of the parent vessel with use of a self-expanding stent followed by coil embolization offers a promising therapeutic alternative for wide-necked aneurysms not amenable to coil embolization alone. Although immediate angiographic results are promising, long-term angiographic and clinical follow-up is essential to determine permanent vessel patency and aneurysm occlusion rate.     

Neuroform颅内支架辅助栓塞宽颈颅内动脉瘤的初步经验

目的　报道我科使用Neuroform支架辅助可脱式弹簧圈栓塞宽颈脑动脉瘤的初步经验。方法　 2 2例 2 4枚宽颈颅内动脉瘤采用Neuroform支架和弹簧圈进行栓塞 ,其中急性破裂动脉瘤 19枚、未破裂动脉瘤 5枚。结果　支架均成功地释放 ,支架置入后的造影未发现有瘤内造影剂滞留的血流动力学改变。 10 0 %闭塞动脉瘤 18枚 ,90 %以上闭塞 5枚 ,1枚伴发的未破裂小型宽颈动脉瘤在支架置入后微导管无法超选 ,载瘤动脉均通畅。有 2枚动脉瘤虽有支架阻挡 ,但仍有部分弹簧圈畔进入载瘤动脉。所有患者没有出现与支架置入有关的症状性缺血性并发症。 17例造影随访中 ,有 1例在 3个月复查时发现再通 ,进行 2次栓塞完全闭塞动脉瘤 ,其余未见复发 ,结论　Neuroform颅内支架使用安全有效 ,适合于宽颈颅内动脉瘤的支架辅助弹簧圈栓塞 ,特别适合于迂曲的脑血管 ;其径向支撑力较差 ,在输送微导管时应防止其移位 ;其支架网眼较大 ,对血流动力学改变不明显 ,致密填塞是重要的 ,在输送弹簧圈时仍应防止弹簧圈畔进入载瘤动脉 ;术前、术后抗血小板药物的应用以及术后严格的系列造影随访是必要的。     

Flow changes after endovascular treatment of a wide-neck anterior communicating artery aneurysm by using X-configured kissing stents (cross-kissing stents) technique

Endovascular treatment for a wide-neck anterior communicating artery (AcomA) aneurysm remains technically challenging. Stent-assisted embolization has been proposed as an alternative of treatment of complex aneurysms. The X-configuration double-stent-assisted technique was used to achieve successful coiling of wide-neck AcomA aneurysm. Implanted stent can alter intra-arterial flow. Follow-up angiograms 4 months later showed flow changes due to used X-technique of stents implantation and filling of the anterior cerebral artery from the opposite internal carotid artery.     

Horizontal stent placement plus coiling in a broad-based basilar-tip aneurysm: an alternative to the Y-stent technique

Introduction Basilar tip aneurysms are the most frequent type of aneurysm in the posterior circulation. Specifically, if wide-necked, they remain a significant therapeutic challenge. On the endovascular side, stents may help to overcome many of these technical challenges. However, if both P1 segments encroach into the aneurysm neck, sometimes stent placement from the middle of the basilar artery to one P1 segment is not enough. Therefore, some groups recommend the use of the so-called Y-stent technique, with one stent passing through the interstices of another stent in a Y-configuration thus remodelling the basilar tip.Methods We describe a patient with a broad-based basilar tip aneurysm and a single, very tortuous vertebral artery which did not allow the use of the vertebrobasilar system as the straight route to the aneurysm. Because of the well-known high surgical risk we decided to navigate the stent through the internal carotid artery and via the posterior communicating artery into the contralateral P1 segment and placed the stent at right angles to the aneurysm from one P1 segment to the contralateral one.Results The outcome in the patients was excellent without any ischemic lesions.Conclusion Horizontal stent placement in wide-necked basilar tip aneurysms may be a therapeutic alternative if the regular route via the vertebral arteries is not feasible.     

Retrograde stenting through the posterior cerebral artery in coil embolization of the posterior communicating artery aneurysm

Introduction

Protection techniques using stents or balloons are occasionally limited in coil embolization of wide-necked posterior communicating artery (PcomA) aneurysms in which the PcomA originated from the aneurysm neck at an acute angle. Here, we present two cases undergoing retrograde stenting through the posterior cerebral artery in coil embolization of the PcomA aneurysms.

Methods

To perform retrograde stenting, a microcatheter used for stent delivery was advanced from the vertebral artery (VA) to the terminal internal carotid artery (ICA) via the ipsilateral P1 and the PcomA. The aneurysm sac was selected with another microcatheter for coil delivery through the ipsilateral ICA. Coil embolization was performed under the protection of a stent placed from the terminal ICA to the PcomA.

Results

Deployment of the stent was successful in both aneurysms treated using retrograde stenting by the VA approach. Coil deployment was performed through the jailed microcatheter at first. The microcatheter was repositioned through the stent struts later in one case and another microcatheter was inserted into the sac through the stent struts in the other case. Both aneurysms were occluded properly with the coils without procedure-related complications.

Conclusion

By providing complete neck coverage, retrograde stenting for coil embolization in wide-necked PcomA aneurysms seems to be a good alternative treatment strategy, when the aneurysms are incorporating extended parts of the PcomA, and the PcomA and P1 are big enough to allow passage of the microcatheter for delivery of the stent. However, this technique should be reserved for those cases with the specific vascular anatomy.     

Treatment of a wide-necked aneurysm of the anterior cerebral artery using two Enterprise stents in “Y”-configuration stenting technique and coil embolization: a technical note

The endovascular treatment of wide-necked aneurysms remains challenging. The “Y”-stenting technique has been used for stent-assisted coil embolization of wide-necked bifurcation aneurysms. So far, this technique has been described for aneurysms of the basilar apex or the middle cerebral artery bifurcation and only for open stent systems using the Neuroform stent. We report a 52-year-old woman with recurrence of a wide-necked aneurysm of the anterior cerebral artery that was successfully retreated by stent-assisted coiling using the “Y”-stenting technique with the Enterprise stent system.     

Enterprise支架辅助弹簧圈栓塞治疗前交通宽颈动脉瘤的临床研究

目的初步探讨和总结应用EnterPrise支架辅助弹簧圈栓塞治疗前交通宽颈动脉瘤的技术及疗效。方法收治8例前交通宽颈动脉瘤(体/颈比<1.5)患者,均采用Enterprise支架辅助水解脱弹簧圈栓塞,其中6例先放置支架覆盖动脉瘤颈再将微导管经支架网孔放入动脉瘤腔填塞弹簧圈进行栓塞,2例在微导管进入瘤腔后再释放支架进行弹簧圈栓塞。术后6～12个月进行临床和DSA随访。结果 8例全部技术成功,支架到位满意,载瘤动脉通畅,无手术并发症;其中动脉瘤完全闭塞7例,闭塞95%以上1例,患者术后均恢复良好,临床随访6～12个月无再出血及脑血栓形成,其中DSA随访6例无支架狭窄及动脉瘤再通。结论 Enterprise支架辅助弹簧圈栓塞治疗前交通宽颈动脉瘤是一种安全、可靠、有效的治疗方法,但其长期疗效仍需进一步观察。