支架辅助弹簧圈治疗颅内复杂动脉瘤

目的探讨支架辅助弹簧圈治疗颅内复杂动脉瘤的方法和疗效。方法本组17例复杂颅内动脉瘤,1例采用2枚支架重叠置入动脉瘤段载瘤动脉内,16例经支架网眼送入弹簧圈行瘤腔栓塞。结果17例置入支架20枚,其中1例栓塞后出现肢体轻度麻木无力,对症处理后恢复;7例夹层动脉瘤和1例梭形动脉瘤疏松填塞。随访6￣24个月。DSA复查,示8例动脉瘤消失,1例发现置入支架上段又出现夹层动脉瘤,再次置入支架1枚及弹簧圈栓塞后,动脉瘤消失。1例置入2枚支架者1年后MRA复查示动脉瘤缩小70%。1例栓塞后2个月出现短暂性脑缺血发作者,行TCD检查,发现支架段血管狭窄,服抗凝药继续观察;其余6例行MRA、CTA检查未见动脉瘤复发。结论支架辅助弹簧圈治疗颅内复杂动脉瘤是行之有效的方法。     

辅助栓塞技术治疗颅内复杂动脉瘤的临床应用(附36例报告)

目的 探讨多种辅助栓塞技术治疗颅内复杂动脉瘤的临床应用.方法 共36例患者的41个颅内复杂动脉瘤行辅助栓塞治疗,方法包括球囊、支架辅助栓塞和双微导管栓塞技术.结果 宽颈动脉瘤33个,其中球囊辅助栓塞11例,完全栓塞7例,次全栓塞3例,另外1例因球囊放置困难改用双微导管栓塞技术;支架辅助栓塞15例,完全栓塞10例,次全及部分栓塞各2例,单纯支架植入1例;双微导管技术栓塞8例,完全栓塞6例,次全及部分栓塞各1例.梭形动脉瘤8个,全部行支架辅助栓塞,完全栓塞1例,次全栓塞6例,单纯支架植入1例.3例出现并发症,其中术中血栓形成2例,术后视野缺损1例.结论 球囊、支架辅助和双微导管栓塞技术是治疗颅内复杂动脉瘤安全有效的方法,具体应根据动脉瘤部位、形态和患者临床情况进行选择.

Abstract：

Objective To investigate the application of assisted coiling techniques in the treatment of complex intracranial aneurysms.Methods From Jun.2007 to Aug.2010, 36 patients with 41 complex intracranial aneurysms were treated by varient endovascular methods, including balloon, stent-assisted coiling and double microcatheter coiling techniques.Results Among the 33 wide-neck aneurysms, 11cases underwent balloon-assisted coiling, in which 7 were totally occluded, 3 subtotally occluded, 1 diverted to double microcatheter treatment after failure balloon placement 15 cases underwent stent-assisted coiling, in which 10 were totally occluded, 2 subtotally or partially occluded respectively, 1 by single stent placement without coiling.8 cases accepted double microcatheter treatment, 6 were totally occluded, 1 subtotally occluded and 1 partially occluded.All 8 fusiform aneurysms were treated by stent-assisted coiling, one case was totally occluded, 6 subtotally occluded, and another one was treated by single stent placement.The complications were found in 3 patients, including intra-operative thrombosis in 2 cases and dysopia in one case.Conclusion Balloon, stent-assisted coiling and double microcatheter techniques are safe and effective in treating complex intracranial aneurysms, but it should be determined by the position and morphologic characteristics of aneurysms as well as the patients' clinical condition.     

颅内破裂微小动脉瘤介入栓塞术临床疗效和安全性研究

目的探讨介入栓塞颅内破裂微小动脉瘤的技术要点,评价其临床疗效和安全性。方法回顾性分析2014年4月-2016年10月云浮市人民医院因微小颅内动脉瘤破裂致蛛网膜下腔出血而行介入栓塞治疗患者的临床资料,评价栓塞治疗的临床疗效、手术并发症及患者预后情况。结果研究共纳入23例微小颅内动脉瘤破裂患者,均在全身麻醉下采用弹簧圈栓塞治疗,其中17例采用单纯弹簧圈栓塞,6例采用支架辅助治疗。致密栓塞19例(82.61%),4例(17.39%)瘤颈残余。所有患者载瘤动脉均通畅,术中无动脉瘤破裂出血,1例(4.35%)术中发生载瘤动脉狭窄闭塞,置入支架后载瘤动脉恢复通畅。术后6~30个月DSA随访均无再出血。1例(4.35%)瘤颈残余患者1年后出现瘤颈部动脉瘤复发,给予支架辅助栓塞治疗。23例患者术后6个月时改良Rankin量表(modified Rankin Scale,mRS)评分0分共21例,2分有2例。结论介入栓塞技术治疗颅内破裂微小动脉瘤是一种安全、有效的治疗手段,术后治疗效果良好。     

106例颅内复杂动脉瘤的支架应用

目的 总结血管内支架技术辅助弹簧圈治疗颅内复杂动脉瘤的疗效，探讨其技术要点、并发症防治及评估该技术的安全性。方法 回顾性分析106例颅内复杂动脉瘤血管内支架技术应用。单纯支架技术6例，一期支架辅助弹簧圈治疗动脉瘤59例，二期支架结合弹簧圈栓塞动脉瘤40例，一期治疗病例中，先放微导管后放支架28例，先放支架后放微导管31例。结果 106例患者宽颈动脉瘤60例，梭形动脉瘤25例、夹层动脉瘤15例、假性动脉瘤6例。支架无法到位1例，105例第一次栓塞术后即时造影动脉瘤完全栓塞70例(66．7％)，动脉瘤大部分栓塞35例(33．3％)。术中动脉瘤破裂3例，术后脑梗塞4例，支架移位4例。80例3个月至24个月造影随访，动脉瘤消失50例(62．5％)，部分残留30例(37．5％)，其中20例行再次弹簧圈栓塞，完全栓塞15例(75％)。80例两次完全栓塞共65例(82．5％)。临床随访105例病人死亡1例，术后遗留永久性神经功能障碍2例。结论 支架技术辅助微弹簧圈栓塞提高了颅内复杂动脉瘤的近期疗效，是治疗颅内复杂动脉瘤的一种有效方法，但长期疗效尚有待进一步的随访研究。     

颅内巨大动脉瘤的血管内治疗

目的探讨颅内巨大动脉瘤（GAs）血管内治疗的技术和疗效。方法回顾分析42例GAs血管内治疗病人的临床资料。结果29例载瘤动脉闭塞病人中,1例术后2月死于蛛网膜下腔出血,1例术后3个月出现脑缺血症状。9例弹簧圈栓塞和支架结合弹簧圈栓塞的病人,1例完全栓塞,8例有不同程度的弹簧圈移位。4例覆膜支架病人,1例术后6小时GAs再次破裂导致死亡,3例GAs闭塞。结论血管内治疗GAs是安全、有效的,首选载瘤动脉闭塞,弹簧圈部分栓塞能够减低动脉瘤破裂的风险,支架结合弹簧圈栓塞能够增加动脉瘤致密栓塞的可能,降低复发率,随着材料和工艺的发展优化,覆膜支架有希望成为最佳的治疗选择。     

支架结合弹簧圈治疗颅内大型动脉瘤的初步探讨

目的 分析颅内支架辅助弹簧圈栓塞治疗颅内大型动脉瘤疗效.方法 回顾性分析采用颅内支架结合弹簧圈治疗12例颅内大型动脉瘤患者的临床资料.应用支架包括Neuroform 4枚和Enterprise 8枚.结果 12枚支架均成功释放,所有支架辅助弹簧圈栓塞术后即刻造影,其中动脉瘤获致密栓塞9例,瘤颈残留1例,瘤体显影2例.出院时改良Rankin量表(mRS)评分0～2分9例,3～4分2例,5分1例.术后6个月随访复查造影11例,其中动脉瘤获致密栓塞8例,均未见复发;瘤颈残留1例,术后6～12个月复查示瘤颈显影明显减淡;瘤体显影2例,术后12个月复查示瘤腔消失.结论 支架辅助弹簧圈栓塞颅内大型动脉瘤能保持载瘤动脉通畅,动脉瘤栓塞致密,安全有效.     

血管内支架在颅内宽颈及梭形动脉瘤栓塞治疗中的应用

目的　探讨使用血管内支架结合电解可脱卸弹簧圈 (GDC)治疗颅内梭形及宽颈动脉瘤的疗效及并发症。方法　将冠脉支架横跨于 6例颅内梭形动脉瘤 2 4例宽颈动脉瘤瘤颈后释放 ,通过支架的网孔在动脉瘤腔填塞GDC。结果　 2 6例动脉瘤致密填塞 ,4例大部分填塞 ,载瘤动脉通畅。除 5例发生支架移位 ,2例颈内动脉一过性痉挛外 ,无其他手术并发症 ,患者均恢复良好。结论　血管内支架作为腔内隔绝物 ,结合GDC是治疗颅内梭形及宽颈动脉瘤的有效方法     

Lvis支架在颅内宽颈动脉瘤栓塞中的应用

目的 探讨Lvis支架在颅内宽颈动脉瘤栓塞术中的应用效果。方法 对2014年7月至2015年12月应用Lvis支架辅助栓塞治疗的15例宽颈动脉瘤的临床资料进行回顾性分析,评估其疗效。结果 15例中,Raymond Ⅰ级栓塞11例,Ⅱ级3例,Ⅲ级1例;有效栓塞率93.3%。栓塞过程中未发生动脉瘤破裂。术中发生1例血栓事件,经立即溶栓等处理后闭塞动脉再通,但该病人术后1周死于心肌梗死。术后2例出现对侧肢体活动障碍并意识障碍,经肝素化及加大替罗非班用量后好转。所有存活病人术后随访3个月均恢复良好,复查DSA证实动脉瘤均无复发,载瘤动脉通畅。结论 Lvis支架操作简单,各种型号齐全,适合颅内大多数瘤动脉,各项性能均表现良好,适合颅内宽颈动脉瘤的栓塞治疗,但致栓性较强,需重视。     

血管内栓塞治疗颅内微小动脉瘤

目的总结血管内栓塞治疗颅内微小动脉瘤的效果与技术经验。方法回顾分析经血管内栓塞治疗25例（计29枚）颅内微小动脉瘤（瘤体最大长径：2-3mm15枚、1．6-1．9mm14枚）,其中单纯弹簧圈栓塞10枚,球囊辅助栓塞10枚,支架辅助栓塞7枚,单纯支架覆盖瘤颈2枚。结果29枚动脉瘤术后即刻致密栓塞13枚,占44．8％。出院时按改良GOS评分评估预后,25例患者中恢复正常18例、良好2例、一般2例、差1例、死亡2例。23例患者随访6个月～4年,无再出血病例;19例（21枚动脉瘤）复查造影,其中2例（2枚）复发（给予补充致密栓塞）,2例（2枚）行单纯支架覆盖瘤颈的患者见动脉瘤已闭塞。结论血管内治疗微小动脉瘤安全有效,微导管头端合理塑形与技术操作规范是治疗成功的关键。     

血管内治疗颅内动脉瘤33例临床分析

目的探讨血管内治疗颅内动脉瘤的方法及效果。方法33例颅内动脉瘤患者共有37枚动脉瘤,其中28枚采用单纯弹簧圈栓塞,9枚采用支架辅助弹簧圈栓塞。结果完全栓塞30枚,次完全栓塞6枚,不完全栓塞1枚。2例Hunt—HessV级患者死亡;1例支架辅助弹簧圈栓塞患者术后出现再出血,经治疗后痊愈;余患者术后随访1个月～2年,未发生再出血和动脉瘤复发。结论血管内治疗颅内动脉瘤是一种安全、微创、有效的方法。宽颈动脉瘤应用支架辅助技术治疗操作简单、并发症少。     

A single-centre experience and follow-up of patients with endovascular coiling of large and giant intracranial aneurysms with parent artery preservation

Large and giant aneurysms are some of the most challenging vascular pathologies in the central nervous system. Their peculiarities make the surgical and endovascular approaches difficult and frequently limit them by posing risks and complications. Endovascular coil embolization of these lesions is being used increasingly as an alternative. Here we report the clinical experience and follow-up results of the endosaccular packing of 102 consecutive patients with 106 large or giant aneurysms to assess the efficacy and safety of this method. Embolization was completed by packing the aneurysm sac with a variety of commercially available coils. Primary endosaccular coiling, balloon-assisted coiling and stent-assisted coiling were used. The technical feasibility of the procedure, procedure-related complications, angiographic results, clinical outcome and follow-up angiography were evaluated. During admission, immediate angiography demonstrated complete occlusion in 48.1%, neck remnant in 28.3%, and incomplete occlusion in 23.6%. Procedure-related morbidity and mortality was 7.5% and 2.8%, respectively. A favorable clinical outcome (Modified Rankin Scale score of 0-2) was observed in 88.2% of patients (average follow-up time, 56.5 months). No re-hemorrhage of a treated aneurysm occurred. Angiography follow-up was obtained in 77.5% (79/102) patients (average follow-up time, 38.1 months). The overall recanalization rate was 29.6%. Comparison of occlusion class immediately after treatment and at last follow-up showed that 80.2% of the 81 aneurysms (in 79 patients) were stable or had improved. Five stent-assisted aneurysms that were not completely occluded initially had converted to complete occlusion on last follow-up. Nineteen recanalized aneurysms underwent successful re-embolization. No procedural complication was seen at retreatment. We conclude that in treating large and giant intracranial aneurysms, endovascular coiling with parent vessel preservation is a safe and effective technique.     

Solitaire支架辅助栓塞颅内宽颈动脉瘤的临床分析

目的总结Solitaire支架辅助栓塞颅内宽动脉瘤的经验。方法回顾性分析2011年l月至2012年12月应用Solitaire支架辅助弹簧圈栓塞治疗的16例颅内宽颈动脉瘤患者的临床资料,应用弹簧圈微导管穿越支架网孔技术栓塞10例,支架平行释放技术栓塞6例。结果 16例患者支架均成功放置,无手术相关并发症;动脉瘤完全填塞8例,大部分填塞6例,部分填塞2例。16例病人术后随访3-15个月,复查DSA未见动脉瘤显影,动脉瘤颈部与弹簧圈之间没有造影剂充盈;未发生支架相关的并发症。结论 Solitaire支架辅助栓塞颅内宽颈动脉瘤安全、可靠,短期临床疗效较好。     

不同介入方法治疗颅内大型或巨大型动脉瘤的单中心经验

目的 评价不同介入方法治疗颅内大型或巨大型动脉瘤的有效性、并发症发生率以及预后情况。 方法 回顾性分析第二军医大学附属长海医院神经外科自2001年1月～2010年12月采用不同介入方法治疗的134例颅内大型或巨大型动脉瘤患者的临床资料,按患者接受介入治疗方法不同分为4组,其中载瘤动脉闭塞术11例,单纯弹簧圈栓塞20例,支架辅助下弹簧圈栓塞78例,血流导向装置治疗25例,随访时间6～44个月。影像学结果依据改良Raymond评分,临床症状依据改良Rankin量表（modified Rankin Scale,mRS）评分系统评价,分别评价4组患者出院时的预后良好率、末次随访时动脉瘤的治愈率、复发率,预后良好率及手术并发症情况。 结果 载瘤动脉闭塞组出院时的预后良好率是100%,单纯弹簧圈栓塞组为70%,支架辅助弹簧圈组为91%,而血流导向装置组为100%,四组间差异具有显著性（P=0.0030）。载瘤动脉闭塞组末次随访时治愈率是63.6%,单纯弹簧圈栓塞组为5.6%,支架辅助弹簧圈组为37.2%,而血流导向装置组为72%,四组间差异具有显著性（P=0.0002）。载瘤动脉闭塞组末次随访时的复发率为0%,单纯弹簧圈栓塞组为83.3%,支架辅助弹簧圈组为30.8%,而血流导向装置组为0%,四组间差异具有显著性（P＜0.0001）。载瘤动脉闭塞组末次随访时预后良好率为100%,单纯弹簧圈组为75%,支架辅助弹簧圈组为90%,血流导向装置组为100%,四组间差异具有显著性（P=0.0209）。载瘤动脉闭塞组并发症发生率为27.3%,单纯弹簧圈组为30%,支架辅助弹簧圈组为14.1%,血流导向装置组为0%,四组间差异无显著性（P=0.0650）。 结论 在颅内大型或巨大型动脉瘤的介入治疗中,单纯弹簧圈栓塞复发率高,支架辅助弹簧圈栓塞可降低复发率,载瘤动脉闭塞组预后良好率及复发率满意,但并发症发生率偏高,血流导向装置的初步临床结果令人满意。     

破裂出血的椎动脉夹层动脉瘤早期血管内治疗经验

目的 探讨早期血管内介入等综合方法 治疗破裂出血的椎动脉夹层动脉瘤的临床效果.方法 根据椎动脉夹层动脉瘤形态选用不同方法 共治疗14例,其中支架辅助弹簧圈技术治疗6例,双支架治疗4例,动脉瘤及载瘤动脉闭塞治疗4例.术后尽早将血性脑脊液排出,同时防治血管痉挛.结果 术中无栓塞及动脉瘤破裂等并发症.除1例Hunt-Hess Ⅴ级患者死亡外,其余13例均恢复良好.平均随访16个月,无再出血.影像随访13例,支架辅助弹簧圈治疗者仅有1例部分再通;2例双支架治疗患者原扩张已消失,另2例扩张部分明显变小.3例动脉瘤及载瘤动脉闭塞无再通.结论 早期血管内介入治疗破裂出血的椎动脉夹层动脉瘤是安全有效的.根据夹层动脉瘤不同的形态特征,可以选择不同的方法 .     

支架治疗介入栓塞术后复发颅内动脉瘤的回顾性研究

目的 评价支架治疗介入栓塞后复发颅内动脉瘤的可行性、安全性和有效性。
方法 回顾性分析第二军医大学附属长海医院神经外科2006年6月～2013年3月应用支架治疗的介入栓塞术后复发颅内动脉瘤病例,共83例患者、83枚复发动脉瘤。对患者的临床、影像学资料、治疗方案、治疗结果、并发症及预后等进行分析。
结果 所有83例患者共应用93枚支架,支架植入顺利,技术成功率100%。动脉瘤即刻治疗结果,33例单纯支架植入术的病例中,18例（54.5%）术后即刻动脉瘤内造影剂滞留,15例（45.5%）单纯支架植入术后即刻数字减影血管造影（digital substraction angiography,DSA）同术前相比无明显改变。支架结合弹簧圈治疗的50例患者中,按Raymond分级,Ⅰ级11例（22.0%）,Ⅱ级21例（42.0%）,Ⅲ级18例（36.0%）,载瘤动脉均保持通畅。共发生与支架植入术相关并发症2例（2.4%）,均为脑血管痉挛,给予动脉灌注罂粟碱后好转,出院时无神经功能损害。出院时改良Rankin量表（modified Rankin Scale,mRS）评分：0～2分82例（98.8%）,3分1例（1.2%）。影像学随访50例（60.2%）患者,随访时间2～52个月,中位随访时间11个月。单纯支架植入随访20例结果显示：致密栓塞14例（70.0%）,动脉瘤内进一步血栓形成3例（15.0%）,动脉瘤稳定3例（15.0%）。支架辅助弹簧圈栓塞30例随访结果为：致密栓塞20例（66.7%）,进一步血栓形成3例（10.0%）,稳定3例（10.0%）,小复发2例（6.7%）,大复发1例（3.3%）,再次破裂出血1例（3.3%）。所有患者均获临床随访,随访时间2～82个月,中位随访时间30个月,除发生再出血的患者接受再次治疗并痊愈外,均无新发神经功能缺损。
结论 颅内支架治疗颅内复发动脉瘤技术上可行,安全性高,结果满意,但长期疗效仍有待进一步随访。     

颅内动脉瘤的个体化血管内介入治疗

目的探讨个体化血管内介入治疗颅内动脉瘤的经验。方法回顾性分析30例颅内动脉瘤病人(32个动脉瘤)的临床资料,均采用血管内介入治疗。其中行单纯弹簧圈栓塞治疗动脉瘤15个,支架辅助弹簧圈栓塞治疗12个,球囊辅助弹簧圈栓塞治疗2个,载瘤动脉闭塞治疗3个。结果动脉瘤致密栓塞22个,大部栓塞7个,载瘤动脉闭塞后不显影3个。术中动脉瘤破裂2例,严重血管痉挛1例。随访1～72个月,恢复良好25例,轻残1例,重残1例,死亡3例。结论个体化血管内介入治疗是处理颅内动脉瘤安全、有效的方法;合理选择介入技术及正确处理并发症是治疗成功的关键。     

LVIS支架辅助栓塞治疗颅内后循环动脉瘤的疗效

目的 探讨LVIS支架辅助栓塞治疗颅内后循环动脉瘤的安全性及有效性。方法 回顾性分析2015年9月至2018年5月采用LVIS支架辅助栓塞治疗的39例（40个动脉瘤）颅内后循环动脉瘤的临床资料。采用单支架27例（单支架组）,双支架12例（双支架组）。结果 39例共使用LVIS支架51枚,其中40枚支架释放时一次性完全打开,10枚释放支架后采用导管导丝按摩技术后完全打开,1枚支架打开不完全。单支架组和双支架组围手术期并发症发生率（0% vs. 11.1%）无统计学差异（P>0.05）。术后即刻造影显示:单支架组和双支架组有效栓塞率（92.6% vs. 91.7%）无统计学差异（P>0.05）。术后6个月DSA复查:单支架组和双支架组动脉瘤完全闭塞率（77.7% vs. 75.0%）及复发率（7.4% vs. 8.3%）均无统计学差异（P>0.05）。术后6个月改良Rankin量表评分0分19例,1分15例,2分2例,3分3例。结论 LVIS支架辅助栓塞治疗颅内后循环颅内动脉瘤效果满意,短期影像学随访显示双支架辅助栓塞结果并不优于单支架组。     

Blister-like aneurysms of the supraclinoid internal carotid artery: Challenging endovascular treatment with stent-assisted coiling

'Blister-like' aneurysms of the supraclinoid segment of the internal carotid artery are usually small and have fragile walls, necessitating special care to prevent rebleeding. These lesions are considered high-risk aneurysms because of the technical difficulties associated with their surgical and endovascular treatment. In this report, we describe the use of stent-assisted, repeated coil embolization in the treatment of a ruptured blister-like aneurysm that experienced rapid growth. Stent-assisted coil embolization is an alternative, but sometimes hazardous, treatment for select blister-like aneurysms. Careful serial follow-up angiography will provide documentation as to the long-term stability of the endovascularly treated blister-like aneurysm described here, but early results are encouraging. Alternatively, placement of telescoped stents or graft-stent devices offers promise for future endovascular therapy.     

Endovascular Treatment of Wide-Necked Intracranial Aneurysms : Techniques and Outcomes in 15 Patients

Objective

It is technically difficult to treat wide-necked intracranial aneurysms by the endovascular method. Various tools and techniques have been introduced to overcome the related technical limitations. The purpose of this study was to evaluate the radiologic and clinical results of wide-necked intracranial aneurysm treatment using the endovascular method.

Methods

Fifteen aneurysms in 15 patients were treated by the endovascular method from October 2009 to August 2010. Seven patients presented with subarachnoid hemorrhage (SAH), seven patients had unruptured aneurysms, and one patient had an intracerebral hemorrhage and intraventricular hemorrhage due to an incompletely clipped aneurysm. The mean dome-to-neck ratio was 1.1 (range, 0.6-1.7) and the mean height-to-neck ratio was 1.1 (range, 0.6-2.0). We used double microcatheters instead of a stent or a balloon for the first trial. When we failed to make a stable coil frame with two coils, we used a stent-assisted technique.

Results

All aneurysms were successfully embolized. Eleven aneurysms (73%) were embolized by the double microcatheter technique without stent insertion, and four aneurysms (27%) were treated by stent-assisted coil embolization. One case had subclinical procedure-related intraoperative hemorrhage. Another case had procedure-related thromboembolism in the left distal anterior cerebral artery. During the follow-up period, one patient (7%) had a recanalized aneurysmal neck 12 months after coil embolization. The recurrent aneurysm was treated by stent-assisted coil embolization.

Conclusion

We successfully treated 15 wide-necked intracranial aneurysms by the endovascular method. More clinical data with longer follow-up periods are needed to establish the use of endovascular treatment for wide-necked aneurysm.     

Neuroform支架在颅内宽颈动脉瘤栓塞治疗中的应用

目的评估Neuroform支架对颅内宽颈动脉瘤的栓塞治疗效果。方法11例颅内宽颈动脉瘤使用Neuroform自膨式颅内支架结合电解可脱弹簧圈进行栓塞治疗。将预装好的Neuroform支架系统引入载瘤动脉处,通过同轴导管释放支架覆盖动脉瘤颈;支架释放后,行可脱弹簧圈栓塞术;术后维持全身肝素化48h。结果动脉瘤100%栓塞8例,95%栓塞2例,1例后交通动脉瘤,在支架释放后,颈内动脉痉挛,放弃栓塞,改为二期栓塞治疗。4例术后6个月复查脑血管造影,动脉瘤消失,载瘤动脉通畅。结论Neuroform支架结合电解可脱弹簧圈栓塞颅内宽颈动脉瘤可克服目前血管内治疗的技术障碍,既可保护载瘤动脉通畅,又可改善宽颈动脉瘤栓塞效果。