Willis覆膜支架治疗颈内动脉病变的疗效分析

目的 探讨Willis覆膜支架治疗颈内动脉颅内段病变的安全性及有效性。方法 回顾性分析2015年1月至2018年5月采用Willis覆膜支架治疗的16例颈内动脉病变者的临床资料。结果 16例，颈内动脉海绵窦瘘3例，颈内动脉岩骨段夹层动脉瘤并破裂出血3例，颈内动脉眼段动脉瘤破裂出血2例，颈内动脉虹吸部动脉瘤破裂出血8例。Willis覆膜支架成功治疗16例颈内动脉颅内段病变。术后随访3~6个月，1例术后6个月载瘤动脉轻度狭窄；1例术后3个月患侧颈内动脉闭塞，1例术后残留微小内漏3个月随访造影时内漏消失；16例GOS评分5分。结论 Willis覆膜支架能够安全有效地治疗颈内动脉颅内段病变，但需要更远期随访。

Analysis of curative effects of Willis covered stents on intracranial lesions of internal carotid arteries

Objective To investigate the curative effect of Willis covered stents on the intracranial lesion of internal carotid artery (ICA) and its safety. Methods The clinical data of 16 patients with ICA lesions treated by the covered Willis stents in our department from 2015 to 2018 were analyzed retrospectively. The reexaminations of DSA were performed 3~6 months after the operation in all the patients in order to understand the changes in ICA lesions. The safety and outcomes of the grafted covered stents were evaluated by the clinical and imaging follow-up results. Results The ICA lesions were successfully treated by the covered stents in 16 patients including 3 patients with carotid cavernous fistulae, 3 ICA petrosal bone segment dissecting aneurysms with hemorrhage due to rupture, 2 ICA ophthalmic artery segment aneurysms with hemorrhage due to rupture and 8 ruptured blood-blister-like-aneurysms with hemorrhage, The DSA following up 3~6 months after the treatment showed that the slight stenosis of local ICA occurred in 1 patient 6 months after the operation, the ICA was occluded in 1 patient 3 months after the operation, there was residual minor internal leakage after the placement of the covered stent in 1 patient in whom the internal leakage disappeared 3 months after the operation and the other patients had good clinical outcomes. Conclusions It is suggested that the covered stent-graft can safely and effectively treat the lesions of ICA intracranial segments, but the more long-term follow-up is required in order to understand its safety and curative effects.