Y型支架技术治疗颅内动脉分叉部宽颈动脉瘤  

Endovascular treatment of wide-necked intracranial artery bifurcation aneurysms with Y-stent technique (report of 20 cases)

作　　者：赵开军[1] 杨鹏飞[1] 黄清海[1] 许奕[1] 李强[1] 赵文元[1] 洪波[1] 刘建民[1] 

机构地区：[1]第二军医大学附属长海医院神经外科,上海200433

出　　处：《中国临床神经外科杂志》2013年第6期321-324,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的评估Y型支架技术治疗颅内动脉分叉部宽颈动脉瘤的有效性和安全性。方法回顾性分析2009年1月到2012年6月采用Y支架技术治疗的20例颅内动脉分叉部宽颈动脉瘤患者的临床资料。结果 20例患者共20个动脉瘤(破裂的9个,未破裂的11个),其中使用交叉Y型支架技术治疗16个,平均用平行Y型支架技术治疗4个。术后即刻造影示10个致密栓塞,8个瘤颈残留,2个瘤体残留。造影和临床随访平均时间分别为9个月和17个月,17例完全治愈、2例瘤颈残留、1例复发(再次采用弹簧圈填塞最终获得致密栓塞)。所有患者出院和随访时都预后良好,改良Rankin评分为0～1分。结论采用交叉或平行Y型支架技术治疗一些复杂的颅内动脉分叉部宽颈动脉瘤是安全、有效的。Objective To evaluate the effectiveness and safety of Y-stent technique for wide-necked intracranial artery bifurcation aneurysms. Methods The clinical data of 20 patients with wide-necked intraeranial artery bifurcation aneurysms, which were endovascularly treated by Y-stents technique in our department from January, 2009 and June, 2012, were analyzed retrospectively. Results Twenty patients had 20 intraeranial artery bifurcation aneurysms including 9 ruptured aneurysms and 11 unruptured ones. Of these 20 aneurysms, 16 were treated by the crossing Y-stent technique and 4 with the kissing Y-stent technique. The angiograms immediatery after the endovasular treatment showed that complete occlusion was achieved in 10 aneurysms, with neck remnant in 8 and incomplete occlusion in 2. Follow up （average, 9 months） angiograms were available for 20 aneurysms. All the patients were clinically followed up averagely for 17 months. The follow up outcomes showed that of 20 aneurysms, 17 were completely occluded, 2 had residual neck and 1 which relapsed was completely occluded by coils during the follow-up. All the patients were recovered well when being followed up. Conclusion Y-stent technique is a safe and effective method to treat intracranial artery bifurcation wide-necked aneulwsms.

关 键 词：颅内动脉 分叉部 动脉瘤 Y型支架 血管内治疗 弹簧圈 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R81[医药卫生—临床医学]