LEO自膨式支架结合水解脱弹簧圈栓塞治疗颅内宽颈动脉瘤

目的探讨和总结应用LEO自膨式支架结合水解脱弹簧圈栓塞治疗颅内宽颈动脉瘤的技术及疗效。方法12例颅内宽颈动脉瘤均采用先放置LEO支架覆盖动脉瘤颈再将微导管经支架网孔放入动脉瘤腔填塞水解脱弹簧圈瘤腔进行栓塞，术后6-12个月进行临床和影像学随访。结果12例全部技术成功，载瘤动脉通畅；10例宽颈动脉瘸完全闭塞，1例闭塞〉95％，1例闭塞〈95％；1例后交通动脉瘤栓塞后出现一过性神经功能障碍。经治疗后恢复正常，其余11例恢复顺利：12例临床随访6-12个月无动脉瘤再出血或脑血栓形成，其中DSA随访5例无支架狭窄及动脉瘤复发。结论联合使用LEO自膨式支架和水解脱弹簧圈栓塞治疗颅内宽颈动脉瘤是一种完全有效的．方法，但其长期疗效仍需进一步观察；颅内专用的LEO自膨式支架为宽颈动脉瘤的介入治疗提供了方便，可防止弹簧圈突入载瘤动脉，保持栽瘤动脉通畅。

Combination of LEO self-expandable stents implantation and hydro-detachable coils placement for intracranial wide-necked aneurysms.

Objective To investigate and summarize the technique and efficacy of LEO serf-expandable stents combined with hydro-detachable coils for treatment of intracraniai wide-necked aneurysms. Methods Twelve cases of intracranial wide-necked ancurysms were first implanted with LEO stents across the neck of aneurysms, and then microcatheters were introduced into the aneurysm sac through stent mesh to stuff hydro-detachable coils and embolize aneurysms. Clinic and angiogram follow-up performed for 6 - 12months. Results The treatment succeeded in all 12 eases and the parent arteries were free in all the patients. The total occlusion of aneurysmal cavities was achieved in 10 aneurysms,more than 95% of the aneurysmal cavities was occluded in 1 aneurysms and less than 95 % in 1 aneurysms. One patient of PcoA aneurysm had temporary mild neurodeficit and quickly recovered after treatment. The other 11 cases recoverd well. No rebleeding or symptom related to thrombosis occurred during clinic follow-up for 6-12months. Follow-up angiogram in 5 cases showed no stenosis in segment of the stent and no ancurysmal recurrence. Conclusion Endovascular embolization by LEO stents combined with hydro-detachable coils is a safe and effective method to treat intracranial wide-necked aneurysms. However, the long term effect needs to be proved by foLtowing-up.Intracranial LEO self-expanding stents may make it easy and feasible for the treatment of wide-necked aneurysms,may prevent the coils into the parent artery and restore the patency of parent artery.