Lvis和Solitaire支架辅助弹簧圈治疗未破裂宽颈眼动脉段动脉瘤的效果比较

  目的  探讨比较Lvis和Solitaire支架辅助弹簧圈治疗未破裂宽颈眼动脉段动脉瘤的临床疗效及安全性。  方法  回顾性分析2018年3月—2019年7月在浙江省台州医院应用Lvis或Solitaire支架辅助弹簧圈栓塞的53例未破裂宽颈颈内动脉眼动脉段动脉瘤患者的临床资料，其中Lvis组29例，Solitaire组24例。应用术毕即刻栓塞程度(Raymond分级)和术后6~12个月数字减影血管造影(DSA)随访结果比较2组的手术疗效，手术相关并发症发生情况比较2组的手术安全性。  结果  术后即刻造影结果显示，Lvis组术后即刻达RaymondⅠ级的有24例(82.8%)，Ⅱ级5例(17.2%)，Solitaire组Ⅰ级17例(70.8%)，Ⅱ级6例(25.0%)，另外有1例(4.2%)为Ⅲ级，2组比较差异无统计学意义(P>0.05)。术后6~12个月DSA随访结果显示，Lvis组显著优于Solitaire组(P < 0.05)。Lvis组手术相关并发症发生率为13.8%(4/29)，高于Solitaire组的4.2%(1/24)。  结论  Lvis和Solitaire两种支架在辅助弹簧圈栓塞治疗未破裂宽颈眼动脉段动脉瘤中各有优劣。Lvis支架可能更有利于减少远期复发，而Solitaire支架有更低的并发症发生率。 

A comparative study of clinical efficacy and safety between Lvis and Solitaire stent-assisted embolization for unruptured wide-necked ophthalmic segment aneurysms of internal carotid artery

  Objective  To compare the clinical efficacy and safety of Lvis and Solitaire stent-assisted embolization in the treatment of unruptured wide-necked ophthalmic segment aneurysms of internal carotid artery.  Methods  The clinical data of 53 patients with unruptured wide-necked ophthalmic segment aneurysms treated by Lvis or Solitaire stent-assisted embolization from March 2018 to July 2019 in Taizhou Hospital of Zhejiang Province were analysed retrospectively. A total of 29 patients were treated with Lvis stents, whereas 24 were treated with Solitaire stents. The surgical efficacy of the two groups was compared by Raymond classification based on immediate postoperative angiography, and follow-up results were based on digital subtraction angiography (DSA) at 6 - 12 months. The incidence of perioperative complications was used to compare the safety of the two groups.  Results  Statistical analysis showed no significant differences in patients after the procedure in the instant Raymond classification (P>0.05). DSA immediately after the embolization showed that 24 (82.8%) received Raymond grade Ⅰ and 5 (17.2%) were Raymond grade Ⅱ in the Lvis stent group, whereas 17 (70.8%) received Raymond grade Ⅰ, 6 (25.0%) received Raymond grade Ⅱ and 1 (4.2%) received Raymond grade Ⅲ. The follow-up results based on DSA at 6 - 12 months in the Lvis stent group were better than those in the Solitaire stent group, and the difference was statistically significant (P < 0.05). The incidence of surgery-related complications in the Lvis stent group was 13.8% (4/29), which was higher than 4.2% (1/24) in the Solitaire stent group.  Conclusion  Lvis stent and Solitaire stent-assisted coil embolization have their own advantages and disadvantages in the treatment of unruptured wide-necked ophthalmic segment aneurysms of the internal carotid artery. Lvis stent-assisted embolization for unruptured wide-necked ophthalmic segment aneurysm is beneficial to decrease recurrence rate, whereas Solitaire stent has a good safety level.