Enterprise支架辅助弹簧圈栓塞治疗前交通宽颈动脉瘤的临床研究  

Enterprise stent-assisted coil embolization for wide-necked anterior communicating artery aneurysms:a clinical study

作　　者：黄海东[1] 顾建文[1] 杨春敏[2] 赵凯[1] 匡永勤[1] 林龙[1] 贺伟旗[1] 杨涛[1] 夏勋[1] 张辉[1] 

机构地区：[1]成都军区总医院神经外科,成都610083 [2]成都军区总医院医学影像科,成都610083

出　　处：《介入放射学杂志》2012年第7期536-540,共5页Journal of Interventional Radiology

摘　　要：目的初步探讨和总结应用EnterPrise支架辅助弹簧圈栓塞治疗前交通宽颈动脉瘤的技术及疗效。方法收治8例前交通宽颈动脉瘤(体/颈比<1.5)患者,均采用Enterprise支架辅助水解脱弹簧圈栓塞,其中6例先放置支架覆盖动脉瘤颈再将微导管经支架网孔放入动脉瘤腔填塞弹簧圈进行栓塞,2例在微导管进入瘤腔后再释放支架进行弹簧圈栓塞。术后6～12个月进行临床和DSA随访。结果 8例全部技术成功,支架到位满意,载瘤动脉通畅,无手术并发症;其中动脉瘤完全闭塞7例,闭塞95%以上1例,患者术后均恢复良好,临床随访6～12个月无再出血及脑血栓形成,其中DSA随访6例无支架狭窄及动脉瘤再通。结论 Enterprise支架辅助弹簧圈栓塞治疗前交通宽颈动脉瘤是一种安全、可靠、有效的治疗方法,但其长期疗效仍需进一步观察。Objective To preliminarily investigate and summarize the technique of Enterprise stent- assisted coil embolization for wide- necked anterior communicating artery aneurysms, and to discuss its clinical efficacy. Methods Eight cases with wide-necked anterior communicating artery aneurysms （body- to-neck ratio 〈 1.5） were treated with Enterprise stent-assisted embolization using hydro-detachable coils. In six patients, the Enterprise stent was implanted first to cover the neck of the aneurysm, then the microcatheter was introduced into the aneurysm sac through stent mesh, and the aneurysm was stuffed with hydro-detachable coils. In the remaining two cases, the microcatheter was introduced into the aneurysm sac first, which was followed by implantation of Enterprise stent to perform embolization with coils. All the patients were clinically followed up for 6 - 12 months, and follow-up examination with DSA was carried out. Results Technical success was achieved in all 8 patients. The stents were optimally located and the parent arteries remained patent. Complete occlusion of aneurysmal cavity was achieved in 7 cases, and over 95% occlusion of aneurysmal cavity was obtained in one case. During the follow-up period, all patients recovered from the illness. Angiography showed that neither in-stent stenosis nor aneurysm re-canalization was seen. Clinically, no procedure-related complications such as re-bleeding or thrombosis occurred. Conclusion For wide-necked anterior communicating artery, Enterprise stent-assisted coil embolization is a safe, reliable and effectivetreatment although its long term effectiveness needs to be further studied.

关 键 词：颅内动脉瘤 宽颈 前交通动脉 支架 弹簧圈 栓塞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]