血管内治疗22例颅内复杂动脉瘤的临床分析

目的探讨血管内应用支架治疗颅内复杂动脉瘤的疗效,评价应用支架的安全性和可行性。方法回顾性分析血管内支架植入治疗22例复杂动脉瘤的临床资料。支架辅助动脉瘤栓塞术14例,单纯支架植入术8例。结果在22例患者中宽颈动脉瘤12例,梭形动脉瘤6例,夹层动瘤2例,巨大动脉瘤2例。22例血管内治疗均成功。动脉瘤完全不显影14例(63.63%),大部分不显影7例(31.82%),稳定1例(4.55%)。手术后随访3-24个月,1例术后1月未服抗血小板药物导致急性大面积脑梗死死亡,其余患者均恢复良好,没有因治疗发生出血、脑缺血事件。结论血管内治疗颅内复杂动脉瘤中应用支架能够提高治疗颅内复杂动脉瘤疗效,在治疗中选用适宜支架安全、可行。

Clinical analysis of endovascular therapy for 22 patients with intracranial refractory aneurysms

Objective To explore the clinical efficacy of endovascular stent implantation in the treatment of intracranial refractory aneurysms,and to evaluate its safety and validity.Methods The clinical data of 22 patients with intracranial complex aneurysm who were treated with endovascular stent implantation were analyzed retrospectively.The stent-assisted coil for embolization intracranial aneurysms were performed in 14 patients,and simple endovascular stent implantation in 8 patients.Results Of 22 patients,wide necked aneurysms were found in 12 patients,fusiform intracranial aneurysms in 6 patients,dissecting aneurysms in 2 patients,and giant aneurysms in 2 patients.All patients successfully completed the endovascular therapy.Among 22 patients,aneurysm were completely obliterated in 14 patients(63.63%),incompletely obliterated in 7 patients(31.82%),and showed no obvious change in one patient(4.55%).After follow-up for 3-24 months,21 patients recovered,and the one who had not taken orally antiplatelet drugs died of acute cerebral infarction with large area one month after operation.No hemorrhage recurrence or cerebral ischemic events occurred during the endovascular therapy.Conclusion Endovascular stent implantation can increase the efficacy for patients with intracranial refractory aneurysms.The appropriate stent is safe and feasible in the endovascular therapy for intracranial refractory aneurysm.