摘要
目的探讨网孔支架辅助微弹簧圈在已破裂颅内动脉瘤栓塞治疗过程中的操控性、相关并发症及临床疗效。方法回顾性分析应用网孔支架辅助微弹簧圈栓塞治疗60例已破裂颅内动脉瘤患者资料。结果所有60枚支架顺利释放到位。术后即刻造影,动脉瘤获100%栓塞34个,95.0%栓塞11个,90.0%栓塞14个,80.0%栓塞1个。术中出现血管痉挛4例,动脉瘤破例3例,血栓形成1例。术后随访3～18个月,死亡2例,患者术后生存质量与术前(Hunt-Hess分级)有统计学差异(P<0.05)。患者术后获影像学随访23例,其中DSA随访19例,1例出现支架内血管狭窄,均无动脉瘤复发。结论使用网孔支架辅助微弹簧圈栓塞治疗已破裂颅内动脉瘤具有操作性良好、安全性高等优点;术者娴熟的技术、对手术时机的准确把握和对介入材料的正确选择有助于减少并发症。
Objective To explore the handling, complications and clinical efficiency of mesh stent- assisted micro-coil in the treatment of ruptured intracranial aneurysms. Methods The clinical data of 60 patients with ruptured intracranial aneurysms and treated with mesh stent-assisted micro-coil in our department from January 2009 to April 2012 were collected in this study. The efficiency was evaluated with modified Rankin scale and Hunt-Hess scale. Results All 60 stents were successfully released in right place. The aneurysm was 100% embolism in 34 cases, 95% embolism in 11 cases, 90% embolism in 14 cases, and 80% embolism in 1 case. The complications of surgery included the vasospasm in 4 patients, the rupture of aneurysms in 3 patients and the thrombosis in 1 patient. All patients had been followed up for 3 to 18 months after surgery, and 2 of them were died. There were significant differences in the patients＇ postoperative quality of life and the preoperative Hunt-Hess scale （P 〈 0. 05 ）. There were 23 cases receiving postoperative imaging during follow-up, including DSA in 19 cases. No aneurysm recurrence was found, and 1 case appeared stent vascular stenosis. Conclusion It is satisfying to use mesh stent-assisted micro-coil to treat ruptured intracranial aneurysms. The stent has good compliance, therefore it can be delivered and deployed easily and positioned precisely with high safety and efficacy. The complications could be reduced by adept technology, accurate grasping the timing of surgery and choosing the intervention material.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2013年第4期339-342,共4页
Journal of Third Military Medical University
关键词
破例颅内动脉瘤
网孔支架
微弹簧圈
血管内治疗
ruptured intraeranial aneurysms
mesh stents
micro-coil
endovascular treatment
