支架辅助栓塞脑宽颈动脉瘤的临床随访研究  

Stent- assisted embolization for wide-necked cerebral aneurysms： clinical follow-up

作　　者：刘爱华[1] 贾建文[1] 彭汤明[1] 钱增辉[1] 吴京[1] 李佑祥[1] 姜除寒[1] 吴中学[1] 杨新健[1] 

机构地区：[1]首都医科大学附属北京天坛医院北京市神经外科研究所,100050

出　　处：《中华神经外科杂志》2013年第7期689-692,共4页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（30901557,81220108007,81171079）;“十二五”国家科技支撑计划（2011BA108B00）;国家重点基础研究发展计划（973计划,2010CB732605）;北京市高层次人才培养计划（2011-3-036,2009-3-22）;北京科技新星培养计划（207-A-043）

摘　　要：目的总结和评估本组使用支架辅助弹簧圈栓塞脑宽颈动脉瘤患者的临床结果和血管造影结果。方法2009年4月至2011年10月，共有169例宽颈动脉瘤患者应用Enterprise支架辅助弹簧圈栓塞。利用统计方法评价分析栓塞程度、临床结果、血管造影结果及栓塞相关并发症等。结果169例患者中，共有166（98．2％）例患者（179枚宽颈动脉瘤）支架释放满意。术中即时造影显示101枚动脉瘤（56．4％）完全栓塞，55枚动脉瘤（30．7％）近全栓塞。接受血管造影随访患者共108例，平均随访时间8．1个月，造影显示95枚动脉瘤（79．8％）为完全栓塞，12枚动脉瘤（10．1％）为近全栓塞。166例患者中6例发生血栓（其中症状性血栓形成5例，无症状性血栓形成1例），术中动脉瘤破裂出血死亡1例。造影随访108例患者中共有10例患者（10枚动脉瘤）复发，均行二期栓塞，栓塞结果满意。结论Enterprise支架对宽颈动脉瘤的辅助栓塞具有较好的安全性和有效性，完全栓塞率较高以及并发症率较低。Objective To summarize and assess our clinical and angiographic results of using the stentassisted coil embolization to wide - necked cerebral aneurysms. Methods From April 2009 to October 2011, our clinical had a total of 169 patients with 182 wide - necked cerebral aneurysms treated with the Enterprise stent. Procedural data, procedure -related complications, angiographic results, and clinical outcomes were reviewed and evaluated. Results A total of 166 （98. 2% ） patients stent deployment was satisfactory. Instant angiographic results revealed that complete occlusion was shown in 101 aneurysms （56. 4% ） and near - complete occlusion was shown in 55 aneurysms （30. 7% ）. A total of 108 patients were used angiographie follow- up, and the mean follow- up time is 8. 1 months. 95 aneurysms （79. 8% ） showed complete occlusion,and 12 aneurysms （10. 1% ） showed near- complete occlusion. All of the 166 patients have a total of 7 patients with complications, including 5 patients with symptomatic thrombosis, 1 patient with asymptomatic thrombosis, 1 death due to aneurysm rupture. A total of 10 patients （9. 3%, 10/ 108） recurrence underwent two embolizations, all of which were subsequently recoiled with satisfactions. Conclusion Enterprise has a good safety and efficacy of stent - assisted embolization of wide - necked aneurysms with a high rate of complete occlusion and a low incidence of complications.

关 键 词：支架 支架辅助弹簧圈栓塞 脑宽颈动脉瘤 

分 类 号：R743[医药卫生—神经病学与精神病学]