覆膜支架治疗颅内动脉疾病的临床分析  

Treatment of intracranial arterial lesions with covered stents

作　　者：张鸿祺[1] 支兴龙[1] 张鹏[1] 李萌[1] 吉训明[1] 缪中荣[1] 王亚冰[1] 卢小健[1] 史怀璋[2] 祁大勇[3] 柳江[4] 肖泉[5] 秦晓红[1] 宋庆斌[1] 王玉林[1] 张虹[1] 凌锋[1] 

机构地区：[1]首都医科大学宣武医院神经外科介入放射诊断治疗中心,北京100053 [2]哈尔滨医科大学第一附属医院神经外科 [3]唐山市工人医院神经外科 [4]北京市海淀医院神经外科 [5]广西壮族自治区人民医院神经外科

出　　处：《中国脑血管病杂志》2006年第9期388-394,共7页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨覆膜支架在治疗颅内动脉疾病中应用的可行性和适应证。方法使用覆膜支架行病变隔绝术治疗20例患者。根据靶血管的直径和病变的长度,选择覆膜支架的直径和长度。共治疗椎动脉颅内段动脉瘤5例、颅底以上颈内动脉动脉瘤7例,经蝶手术致颈内动脉破损1例,外伤性颈内动脉动脉瘤3例、外伤性颈内动脉海绵窦瘘3例、颈内动脉海绵窦段狭窄伴自发性颈内动脉海绵窦瘘1例。共使用覆膜支架21枚,裸支架与覆膜支架联合使用3例。结果一次性成功放置支架17例,病变即刻消失14例,术后复查消失3例,操作失败3例。短暂性轻偏瘫1例。结论合理使用覆膜支架是治疗部分颅内动脉病变的良好手段,但覆膜支架的应用也有一定的局限性。Objective We present our preliminary experience on the treatment of intraeranial arterial lesions with covered stent in a series of patients, Methods 20 patients have been treated by using Jostent coronary covered stent deployed in the parent artery across the lesions, which included aneurysms, iatrogenic or traumatic arterial injury, and traumatic carotid-cavernous fistula （TCCF）. The profile of stent was determinded with the diameter of parent artery and the length of lesion. 5 cases of intradural vertebral aneurysms, 7 internal carotid artery （ICA） aneurysms （ 1 petrous, 2 cavernous, 2 ophthalmic, 2 supra- cliniodal segment）, 1 iatrogenic ICA injury, 3 traumatic ICA aneurysms, 3 traumatic carotid cavernous fistula and 1 ICA cavernous segment stenosis with spontanous CCF were treated. 21 Jostent covered stent had been used. Combination of bare stent and covered stent were used in 3 cases. Results Technical success were achieved in 17 cases. Each case had one lesion. Lesions were excluded from circulation in 14 cases. There were 3 cases with lesion reminants or endoleakage just after treatment, but disappeared soon in the follow-up angiography. No complication was found in successful cases. Covered stent deployment were failed in 3 cases. One had transient slight paraplegia. There was no severe complication or death. Conclusion Excluding the lesion from circulation with covered stent has been proved to be an effective reconstructive treatment of intracranial arterial lesions. Further research and development are needed to make the indication even broader.

关 键 词：颅内动脉疾病 血管内治疗 覆膜支架 

分 类 号：R743[医药卫生—神经病学与精神病学]