血管内支架结合弹簧圈治疗颅内宽颈动脉瘤的影像学随访结果

目的 总结血管内支架结合弹簧圈治疗颅内宽颈动脉瘤的影像学随访结果，了解支架技术在脑动脉瘤治疗中的作用。方法 62例颅内宽颈动脉瘤患者接受血管内支架结合弹簧圈栓塞治疗，并在术后行脑血管造影及临床随访。结果 所有患者均成功植入支架，47例动脉瘤达到致密填塞，15例大部填塞，载瘤动脉通畅。1～6个月造影随访56例动脉瘤内无造影剂显影，4例仍有瘤颈残留，1例复发而再次治疗；12～37个月随访43例中，2例瘤颈残余，1例动脉瘤复发，其余完全闭塞，弹簧圈形态无改变。结论 血管内支架植入后明显改变瘤内血流动力学并促进血栓形成，通过促进瘤颈内膜形成达到影像学治愈。

Radiographic follow up results of endovascular stenting combined with coiling on treatment of intracranial wide-necked aneurysms

Objective The radiographic outcomes of endovascular stenting combined with coiling for treating intracranial wide necked aneurysms were summarized for investigating the efficacy of this proceduce. Methods sixty two patients with intracranial wide necked aneurysms were treated with combined stenting and coiling proceduce and all were undergoing clinical and angiographic follow up after the initial treatment. Results The stents were deployed in all aneurysms and total occlusion was obtained in 47 cases and subtotal occlusion in 15 cases. Follow up angiograms during 1 6 months showed complete obliteration in 57 cases, neck remnant with further thrombosis in 4 cases, recanalization in one case which needed another occlusion. 12 37 months follow up angiogram in 43 cases suggested total occlusion in 40 cases with two neck remnant and one recanalization. Conclusions Endovascular stent placement changes flow characteristics and facilitate thrombosis inside the aneurysm pouch resulting in radiographically healing by promoting endothelization at aneurysmal neck.