支架辅助微弹簧圈栓塞颅内宽颈动脉瘤的疗效分析

目的 探讨使用支架辅助微弹簧圈栓塞治疗颅内宽颈动脉瘤的临床疗效及安全性,方法 回顾性分析本院2010年7月～2011年9月采用支架辅助弹簧圈栓塞技术治疗的21例宽颈动脉瘤的患者的临床资料,其中未破裂动脉瘤9例,破裂动脉瘤13例；H-H分级；0级9例,Ⅰ级3例,Ⅱ级5例,Ⅲ级4例；采用Neuroform支架辅助栓塞11例,LEO支架4例,Enterprise支架6例.结果 21例患者支架均得以成功释放,术后立即造影见动脉瘤致密填塞17例,瘤颈残余3例,瘤体少部分显影1例;全组病例均未产生与介入治疗相关的并发症,术后3～6个月均进行DSA造影复查,致密栓塞的17例患者均未见复发,瘤颈残留的3例复查时明显见瘤颈显影明显变淡,瘤体显影的于6个月复查时未见显影.所用病例载瘤动脉均通畅,支架未见移位,结论 使用支架辅助微弹簧圈栓塞技术有利于颅内宽颈动脉瘤的介入治疗,扩大了介入技术在颅内动脉瘤的应用范围,并且大大提高了微弹簧圈栓塞的致密栓塞率.

Efficacy Analysis of Combined Treatment of Endovascuar Stent Implantation and Endovascular Coil Placement for Intracranial Wide-neck Aneurysms

Objective To investigate and summarize the technique and efficacy of the treatment of combined endovascuar stent implantation and endovascular coil placement for intracranial wide-neck aneurysms.Methods From July 2010 to September 2011,21 cases with wide-neck aneurysms,aneurysms ruptured in 13 cases,unruptured in 9 cases,were treated by combining endovascular stent implantation and endovascular coil placement.Among them,according to the H-H classification,9 cases were 0 grade,3 cases grade Ⅰ,5 cases grade Ⅱ,4 cases grade Ⅲ.Neuroform stents implantation with embolism were used in 11 cases,LEO stents in 4 cases,Enterprise stents in 6 cases.Results Twenty-one stents were successful released,and postoperative immediately imaging observation revealed that aneurysms was density filled in 17 cases,residual neck in 3 cases,pseudoaneurysm residual in 1 case.Conclusion The treatment of combined endovascuar stent implantation and endovascular coil placement for intracranial wide-neck aneurysms is safe.