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。

Application of Neuroform Stents to Endovascular Embolization of Intracranial Wide-Necked Aneurysms

Objective To evaluate the effect of Neuroform stents on the occlusion of wide-necked intracranial aneurysms. Methods Eleven patients with a wide-necked intracranial aneurysms were treated by endovascular embolization with stent-assisted coils. Neuroform stent microdelivery system is led into the parent artery. Through the coaxial catheter a Neuroform stent is placed in the aneurysm neck and subsequent coils were delivered into the aneurysm cavity. The postoperative heparinization lasted 48 hours in all the patients, who orally took aspirin (300 mg/day) and clopidogrel (Plavix, 75 mg/day) for one month. Thereafter the administration of aspirin (300 mg/day) lasted 6 months. Results The aneurysms were completely occluded in 8 patients. The occlusion of 95% aneurysms cavites was reached in 2 patients. The vasospasms occurred after deployment of the stent in 1 patient with posterior communicating artery aneurysm, who was cured by re-embolization with coils 1 month after the first embolization. The angiography in 4 patients 6 months after the treatment showed that the aneurysm disappeared and the parent arteries were free in these patients. Conclusion The endovascular embolization with Neuroform stent may improve the curative effect on wide-necked aneurysms and make the parent arteries free.