新型机械可解脱弹簧圈在颅内破裂宽颈动脉瘤栓塞术中的初步应用

目的探讨一种新型可解脱弹簧圈(Prime FC弹簧圈)在颅内破裂宽颈动脉瘤栓塞术中应用的安全性和有效性。方法回顾性分析2020年9月至2021年1月期间连续收治的应用Prime FC弹簧圈成篮栓塞治疗的22例颅内破裂宽颈动脉瘤患者的临床资料,瘤颈宽度>4 mm或瘤体/瘤颈<2。入院时改良Rankin量表(mRS)评分0~2分11例,3分4例,4~5分7例;Hunt-Hess分级Ⅰ~Ⅱ15例,Ⅲ~Ⅳ级7例。术后即刻栓塞效果应用Raymond分级标准进行评估(Ⅰ级为完全栓塞,Ⅱ级为近全栓塞,Ⅲ级为部分栓塞)。结果19例患者应用Prime FC弹簧圈作为首枚成篮圈+填塞弹簧圈实施动脉瘤栓塞治疗,另外3例患者因动脉瘤瘤颈过宽,改为支架辅助Prime FC弹簧圈+填塞弹簧圈栓塞治疗。即时栓塞结果:Raymond分级Ⅰ级18例,Ⅱ级4例;出院时mRS评分0~2分20例,3分2例。无操作相关并发症发生,围手术期无严重脑血管痉挛及脑梗死发生。出院时及出院后1个月内电话随访无脑积水病例发生。结论使用Prime FC弹簧圈作为首枚成篮圈,应用于急性期颅内破裂宽颈动脉瘤的栓塞治疗安全、有效。

Preliminary application in embolization for ruptured wide-necked intracranial aneurysms with new mechanically detachable coils

Objective To explore the safety and effectiveness of new mechanically detachable coils(Prime FC coil)for ruptured wide-necked intracranial aneurysms.Methods Clinical data of 22 patients with ruptured wide-necked intracranial aneurysms treated by the Prime FC coils embolization have been collected from September 2020 to January 2021.Aneurysms were considered as wide-necked if neck width is>4 mm or the aneurysm has a dome-to-neck ratio of<2.The modified Rankin scale(mRS)score at admission was 0-2 in 11 cases,3 in 4 cases,and 4-5 in 7 cases.Hunt-Hess classification wasⅠ-Ⅱin 15 cases,andⅢ-Ⅳin 7 cases.The immediate angiographic results were evaluated according to the Raymond scale(classⅠ:complete embolization;classⅡ:near total embolization;classⅢ:partial embolization).Results Nineteen aneurysms were embolized successfully with Prime FC coils and subsequent packing coils.Another 3 aneurysms were treated with stent assisted Prime FC coils and subsequent packing coils due to overwhelmingly wide aneurysm neck.Immediate post-embolization angiographic results:Raymond classⅠin 18 cases,Raymond classⅡin 4 cases.The mRS score at discharge were 0-2 in 20 cases and 3 score in 2 cases.No operation-related complications occurred,and no cases of severe cerebral vasospasm and cerebral infarction occurred during perioperative period.No hydrocephalus cases occurred at discharge and during 1-month telephone follow-up after discharge.Conclusion The use of Prime FC coil as the first packing coil is safe and effective in the embolization treatment of acute intracranial ruptured wide-necked aneurysm.