Neuroform支架或球囊瘤颈重塑辅助弹簧圈栓塞颅内宽颈动脉瘤

目的探讨使用Neuroform支架或球囊与瘤颈重塑技术辅助弹簧圈栓塞颅内宽颈动脉瘤的疗效。方法207例颅内宽颈动脉瘤中，129例采用Neuroform支架瘤颈重塑技术辅助弹簧圈栓塞，78例采用球囊瘤颈重塑技术辅助弹簧圈栓塞。术后3个月对预后进行改良Rankin量表评分。术后6～12个月复查脑血管造影。结果以Neuroform支架辅助弹簧圈栓塞的78例动脉瘤中，完全栓塞114例，次全栓塞12例，部分栓塞3例。球囊辅助弹簧圈栓塞的动脉瘤中，完全栓塞69例，次全栓塞9例。Neuroform支架辅助组、球囊辅助组的预后良好率分别为：77．2％（98／129）、78．2％（61／78）；预后不良率分别为：22．8％（29／129）、20．5％（16／78）；病死率分别为：1．6％（2／129）、1．3％（1／78）。术后46例患者接受脑血管造影随访，其中Neuroform支架辅助组32例，球囊辅助组14例。影像学随访46例患者中，13例再通，7例影像学好转，26例稳定。结论Neuroform支架或球囊瘤颈重塑辅助弹簧圈栓塞是治疗颅内宽颈动脉瘤的有效方法，但各有其优缺点，应根据宽颈动脉瘤的具体情况选择恰当的方法进行栓塞。

Neuroform stent or balloon-assisted remodeling technique in the coil embolization of intracranial wide-necked aneurysms

Objective To investigate the efficacy of using Neuroform stent or balloon-assisted remod- eling technique in the coil embolization of intracranial wide-necked aneurysms. Methods Of the 207 patients with wide-necked aneurysms, 129 were treated by Neuroform stent-assisted remodeling technique and coil embolization, 78 were treated by balloon-assisted remodeling technique and coil embolization. The prognosis of the patients was evaluated with the modified Rankin scale 3 months after the procedure, and they were reexamined by cerebral angiography 6 to 12 months after the procedure. Results The aneurysms of 114 patients were completely occluded with Nenroform stents in combination with coil emboliza- tion, 12 were subtotally occluded, and 3 were partially occluded. Among the aneurysms treated with balloon-assisted remodeling technique and coil embolization, 69 patients were completely occluded, and 9 were subtotally occluded. The patients had good prognoses in the Neuroform stent-assisted group and balloon-assisted group were 77.2% （98/129） and 78.2% （61/78） , respectively; the poor prognoses were 22.8% （29/129） and 20.5% （16/78）, respectively; and the mortality rates were 1.6% （2/129） and 1.3% （1/78）, respectively. Forty-six patients were followed up with cerebral angiography after the procedures （32 patients in Neuroform stent-assisted group and 14 in the balloon-assisted group）. Thirteen of the 46 patients showed their aneurysms were recanalized, 7 were improved, and 26 were stable. Conclusion Neuroform stent or balloon-assisted remodeling in combination with coil embolization are the effective methods in the treatment of intracranial wide-necked aneurysms, however, they all have their own advantages and disadvantages. It should be selected according to the specific conditions of the wide-necked aneurysms.