支架半释放技术辅助栓塞颅内复杂动脉瘤  

Stent semi-deploying technique for the treatment of complex intracranial aneurysms

作　　者：杨鹏飞[1] 刘建民[1] 洪波[1] 杨志刚[1] 许奕[1] 赵文元[1] 黄清海[1] 

机构地区：[1]上海第二军医大学长海医院临床神经医学中心、神经外科,200433

出　　处：《介入放射学杂志》2009年第10期723-726,共4页Journal of Interventional Radiology

基　　金：上海市自然科学基金项目(08ZR1404200);上海市优秀学科带头人项目(07XD14026);上海市科委重点项目(074119506)

摘　　要：目的初步评价支架半释放技术辅助栓塞颅内复杂动脉瘤的疗效及安全性。方法回顾性分析经支架半释放技术治疗的18例患者共19枚动脉瘤的临床资料,其中未破裂动脉瘤15枚,破裂动脉瘤4枚,按Hunt-Hess分级:Ⅱ级3例,Ⅲ级1例。结果本组病例共应用支架31枚,所有支架均成功释放,动脉瘤致密栓塞7例,瘤颈残留3例,瘤体显影9例;未发生手术相关并发症,术后无新发神经功能缺损,出院时改良Rankin评分(MRS)0分10例,1分4例,2分3例,3分1例。1～3个月的临床随访所有患者恢复良好,临床症状未见加重,亦未发生再出血或新发梗死。结论支架半释放技术辅助栓塞颅内复杂动脉瘤技术上是可行的,与其他支架释放技术相比,可操作性强,安全性高,瘤颈栓塞致密,即刻栓塞结果满意,但其长期疗效有待于进一步随访。Objective To make a preliminary assessment of the safety and efficacy of stent semideploying technique for the treatment of complex intracranial ancurysms. Methods Stent semi-deploying technique was performed in 18 patients with a total of 19 complex intracranial aneurysms. The clinical data were retrospectively collected and analyzed. The average age was （55.3 ±10.1）years. The aneurysms were composed of 15 un-ruptured and 4 ruptured ones. According to Hunt-Hess Gradation, 3 cases were classified as grade Ⅱand one case as grade In. Results Thirty-one stents altogether were employed in this group of patients. All the stents were successfully implanted. Complete occlusion was obtained in 7 aneurysms, aneurysmal neck was left over in 3 eases and aneurysmal sac opacification was seen in 9 cases. No procedure-related complications occurred. After the operation, no new neurological deficit developed. At the time of discharge, the modified Rankin scale（MRS）score was 0, 1, 2 and 3 in 10, 4, 3 and one case, respectively. During the follow-up period of 1-3 months, all patients recovered well and the clinical symptoms showed no aggravation, and no newly-developed bleeding or infarction occurred. Conclusion In treating complex intraeranial aneurysms, stent semi-deploying procedure is technically feasible, which, when compared to other delivery skill, is safe and easy to operate, although its long-term efficacy remains to be further evaluated. （J Intervent Radiol, 2009, 18： 723-726）

关 键 词：颅内动脉瘤 介入治疗 颅内支架 支架半释放技术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]