LEO支架辅助栓塞治疗颅内宽颈动脉瘤

目的探讨颅内专用自膨式支架(LEO支架)在宽颈动脉瘤栓塞治疗的适应证、技术要点、并发症防治,评价该技术的安全性及疗效。方法10例确诊蛛网膜下腔出血患者,介入治疗术前影像学检查或术中DSA造影证实为颅内宽颈动脉瘤破裂所致。术前采用1.5T场强磁共振行MRA或64排螺旋CT容积扫描三维重建,亦可直接行DSA全脑血管造影。首先将LEO支架跨动脉瘤颈放置,通过支架上的网孔将微导管送入动脉瘤腔,填塞弹簧圈。结果10例患者手术均成功。其中1例在第一个LEO支架释放过程中发现支架膨胀不完全,将支架回收入鞘管,撤出体外,更换支架成功释放。支架放置成功后,进行弹簧圈栓塞,填塞过程中反复行DSA动脉造影,至动脉瘤腔内无对比剂充盈,完成栓塞治疗。结论联合使用支架和微弹簧圈是治疗颅内宽颈动脉瘤安全有效的方法,支架使宽颈动脉瘤的介入治疗成为可能。LEO颅内专用自膨式支架,专为适应颅内迂曲血管径路设计,具有支架到位容易、定位准确、可控制释放优点,使支架辅助栓塞颅内宽颈动脉瘤更加安全、有效。

LEO stent for embolization of intracranial wide-necked aneurysms

Objective To discuss indications,technical elements,prevention of complications of the intracranial self-expandable stent(LEO stent) in the wide-necked aneurysm embolization,and to evaluate the technology safety and efficacy.MethodsTen patients with subarachnoid hemorrhage were proved to be wide-necked intracranial aneurysms rupture due by interventional therapy preoperative imaging examination or during interventional proceeder DSA imaging.Preoperative 1.5T magnetic was used to resonance MRA,or 64-slice spiral CT scanning volume three-dimensional reconstruction.DSA for cerebral angiography was used to find aneurysms alone.The LEO stents were implanted across the neck of intracranial wide-necked aneurysms.Microcatheter were introduced into the aneurysms sac through stent mesh.The microcoils were used to embolize the aneurysms.ResultsTen patients were successful.One case in the first LEO stent was found in the release process incomplete stent expansion,the LEO stent will pull back into the sheath,withdrawal of in vitro,successful release of replacement of a new stent.After the success of stent placement,coil was embolizated.In the process of packing coils,DSA angiography was applied repeatedly.Once the aneurysm sac without contrast agent filling,the embolization process completed.ConclusionJoint stent and microcoils is safe and effective in the treatment of intracranial wide-necked aneurysms.LEO stent dedicated intracranial self-expandable stent to meet the intracranial vascular for the tortuous road.A stent has the merit of placing easily,cositioning accuracy,controlling to release.The stent-assisted embolization of intracranial wide-necked aneurysms is safe and more effective.