自膨胀颅内专用支架治疗大脑中动脉宽颈动脉瘤

目的评价自膨胀颅内支架治疗大脑中动脉宽颈动脉瘤的可行性、有效性及安全性。方法回顾性分析采用颅内自膨胀支架治疗16例16个大脑中动脉动脉瘤病人的临床资料。动脉瘤破裂10例，未破裂5例，复发1例；采用单纯支架治疗3例，支架结合弹簧圈栓塞13例。结果本组支架均成功释放。13例采用支架结合弹簧圈治疗的病人中，动脉瘤致密栓塞9例，瘤颈残留1例，瘤体显影3例。术后发生手术相关并发症1例（大脑中动脉上千闭塞，但无临床症状）。出院时改良Rankin评分（MRS评分）0-2分14例。4分1例，6分1例。本组均获临床随访，平均随访18．7个月；无新发神经系统症状，未发生动脉瘤再次破裂出血。9例行影像学随访，平均随访5．8个月；动脉瘤均保持稳定或改善，载瘤动脉无支架内狭窄。结论自膨胀颅内支架治疗大脑中动脉宽颈动脉瘤技术上可行，安全性高。即刻栓塞结果满意；但长期疗效仍有待进一步随访。

Self-expallding intracranial stent for treatment of wide-necked middle cerebral artery aneurysms

Objective To evaluate the feasibility, safety and efficacy of the self-expanding intracranial stents for treatment of wide-necked middle cerebral artery aneurysms. Methods Clinical data of t 6 patients with middle cerebral artery aneurysm, treated with self-expanding intracranial stents, were analyzed retrospectively. There were 10 ruptured, 5 unruptured and 1 recurrent aneurysm. Three aneurisms were treated with stent alone, while the other 13 with stent plus coil. Results All stents were deployed successfully. Among 13 aneurysms treated with stent plus coil, complete obliteration was achieved in 9, residual neck seen in 1 and tumor visualization in 3. Procedure-related complication occurred in 1 patient, whose superior trunk of middle cerebral artery occluded, but no clinical symptoms. The MRS score at discharge was 0-2 in 14 cases, 4 in 1, and 6 in 1. The mean follow-up period was 18.7 months; no neurological deterioration and aneurysm rupture were found. Nine patients got angiographic follow-up of 5.8 months, all aneurysms were stable or improved, no intrastent stenosis occurred. Conclusion Self-expanding intracranial stents for the treatment of middle cerebral artery aneurysms are technically feasible, safe and effective. Further studies are required to evaluate its long-term efficacy.