支架辅助血管内栓塞前交通动脉破裂动脉瘤的疗效

目的 探讨支架辅助栓塞前交通动脉破裂动脉瘤的技术及临床疗效。方法 2005年7月至2015年4月采用支架辅助血管内栓塞治疗前交通动脉破裂动脉瘤21例。结果 栓塞后即刻造影示完全栓塞15例，瘤颈部分残留6例。术中动脉瘤破裂1例，术后再出血2例。21例患者术后随访6~24个月，平均12个月，其中DSA随访15例（9例即刻完全栓塞的患者造影复查动脉瘤仍完全不显影，载瘤动脉通畅；6例栓塞即刻大部分栓塞患者5例动脉瘤级瘤颈未显影，1例瘤颈仍部分显影；术后支架移位2例，载瘤动脉轻度狭窄1例）；所有患者均无神经功能损伤。结论 采用支架辅助血管内栓塞治疗前交通动脉破裂动脉瘤是安全的，复发率低，规范的操作、栓塞材料的合理选择可以降低手术并发症，达到最佳的临床疗效。

Curative effect of stent-assisted endovascular embolization on ruptured anterior communicating artery aneurysms

Objective To investigate the technique of stent-assisted endovascular embolization of anterior communicating artery (ACoA) aneurysms and its clinical effect. Method The clinical data of 21 patients with ACoA aneurysms, which were confirmed by DSA and treated by stent-assisted endovascular embolization from July, 2005 to April, 2015, were analyzed retrospectively, including the technical keys and clinical effect and so on. Results Of 21 patients treated with stent-assisted coiling, 15 received the complete occlusion of the aneurysms and 6 the aneurysmal neck residue. The aneurysm intraoperatively ruptured in 1 patient and postoperative intracranial hemorrhage occurred again in 2 patients. All the patients were followed up from 6 to 24 months (mean, 12 months). Of 15 patients were followed up by DSA, 9 receiving complete occlusion of aneurysms had no recurrent aneurysms, 5 with postoperative aneurismal neck residue received the occlusion of aneurismal necks and 1 with postoperative aneurismal neck residue still had aneurysmal neck residue during the following up. There was the stent shift in 2 patients and there was mild stenosis of the parent artery in 1 patient. Conclusions The stent-assisted coil embolization of ACoA aneurysms is of the advantages such as safety, low recurrence rate and good effect. The postoperative complications can be decreased and the clinical effect can be increased by proper selection of embolismic materials.