Willis覆膜支架在颅内动脉病变治疗中的临床应用

目的 总结 Willis覆膜支架治疗颅内动脉疾病的初步临床经验。方法 回顾性分析2015年10月至2018年2月采用 Willis覆膜支架治疗的13例颅内动脉病变的临床资料。结果 13例中，海绵窦动静脉瘘3例；动脉瘤10例。13例共置入Willis覆膜支架13枚，均一次成功置入支架。9 例动脉瘤术后即刻动脉瘤不显影；1例巨大型动脉瘤术后即刻少量内漏；2例海绵窦动静脉瘘术后即刻病变完全消失，责任动脉通畅；1例海绵窦动静脉瘘术后即刻少量内漏。13例术后随访7~25个月，平均（15±4.6）个月；病变均无复发，责任动脉通畅；2 例术后即刻少量内漏，随访期间内漏自行闭塞；1例CTA显示支架近心端中度狭窄；13例改良Rankin量表评分均为0分，随访期间未出现任何相关临床不适。结论 Willis覆膜支架治疗颅内动脉疾病操作简便，安全有效，但需严格掌握适应证。

Intracranial vascular diseases treated with Willis covered stents (report of 13 cases)

Objective To summarize the experience in treating the intracranial vascular diseases with Willis covered stents. Methods The clinical data of 13 patients with intracranial vascular disease including 10 patients with intracranial aneurysms and 3 with cavernous sinus arteriovenous fistulae(AVF), which were treated by Willis covered stents from October, 2015 to February, 2018, were analyzed retrospectively. Results All the patients were successfully treated with Willis covered stents. DSA immediately after the treatment showed that of 10 aneurysms, 9 were totally occluded and 1 was subtotally occluded, of 3 AVF, 2 were totally disappeared and 1 had a minor internal leakage, and all the parent arteries were free. The following up from 7 to 25 months after the operation showed that all the aneurysms and AVF did not reccurred and the incomplete-occluded aneurysm and AVF spontaneously resolved. The moderate stenosis near the cardiac end of the stent was showed by follow-up CTA in a patient with aneurysm. Conclusions The treatment of intracranial vascular diseases with Willis covered stents is safe and effective, but it is necessary to strictly grasp the therapeutic indications.