LEO+Baby单支架辅助弹簧圈栓塞前交通动脉瘤的有效性及安全性

目的评价专为小血管设计的低剖面、自膨式LEO+Baby单支架辅助弹簧圈栓塞前交通动脉瘤的有效性和安全性。方法回顾性分析应用LEO+Baby单支架辅助弹簧圈栓塞技术治疗的52例前交通动脉瘤患者的临床资料,统计患者基本信息、影像学资料、手术情况及并发症情况。结果52例前交通动脉瘤患者应用LEO+Baby支架51枚,1例患者支架导管到位困难,转开颅手术治疗,其余均操作成功,成功率为98%(51/52);术后即刻造影动脉瘤完全栓塞42例,瘤颈残留9例。术中动脉瘤破裂1例,支架内血栓形成3例,术中弹簧圈脱出1例。术后随访6~12个月,改良Rankin量表(mRS)评分为4~5分2例,2~3分5例,随访无死亡病例。46例患者术后6个月DSA复查结果显示完全栓塞率89.1%(41/46),其余5例未行DSA复查;无支架相关并发症及动脉瘤再破裂出血发生。头颅CT显示,无迟发性脑梗死、脑出血发生。结论应用LEO+Baby单支架辅助弹簧圈栓塞前交通动脉瘤操作成功率和安全性高、围术期并发症少且短期预后良好。

Efficacy and safety of single LEO+Baby stent-assisted coiling in embolization of anterior communicating artery aneurysms

Objective To analyze the efficacy and safety of a low profile and self-expandable single LEO+Baby stent specially designed for small blood vessels to assist coiling in embolization of anterior communicating artery aneurysms.Methods A total of 52 patients with anterior communicating artery aneurysms and treated with LEO+Baby stent-assisted coiling in embolization were analyzed retrospectively.The basic information,imaging data,success rate of operation,and complication of patients were collected.Results A total of 51 LEO+Baby stents were applied to the treatment for 52 patients with anterior communicating artery aneurysms,except 1 patient with difficulty in positioning the stent catheter turned to craniotomy for treatment,and the operation success rate was 98%(51 of 52);prompt angiography after operation showed that aneurysms of 42 cases were completely embolized,and those of 9 cases were remained in aneurysm neck.There were 1 case of aneurysm rupture,3 cases of stent thrombosis and 1 case of coil prolapse during operation.The patients were followed up for a period of 6 months to 12 months,modified Rankins scale(mRS)scores of 2 cases were 4 to 5,those of 5 cases were 2 to 3.No death occurred.A total of 46 patients accepted reexamination with DSA 6 months after operation,which showed a complete embolization rate of 89.1%(41 of 46);the remaining 5 cases didn’t accept DSA reexamination.No stent-related complications or re-rupture or bleeding of aneurysm occurred.Cerebral CT showed no delayed cerebral infarction or cerebral hemorrhage.Conclusion Single LEO+Baby stent assisted endovascular embolization for aneurysm of anterior communicating artery is effective,with high operation success rate and safety,few perioperative complications and good short-term prognosis.