支架半释放技术辅助弹簧圈栓塞破裂颈内动脉前壁动脉瘤  

Embolization of anterior wall aneurysms of internal carotid artery assisted with semi-deploying stent coils technique

作　　者：康伟民[1] 薛德友[2] 李薇[2] 王实[2] 徐菲[2] 白晶波[2] 焦德让[2] 

机构地区：[1]中国人民解放军第二炮兵总医院神经介入科,北京100088 [2]武警后勤学院附属医院神经外科,天津300162

出　　处：《天津医科大学学报》2013年第5期387-389,共3页Journal of Tianjin Medical University

摘　　要：目的:总结应用支架半释放技术辅助弹簧圈急诊栓塞破裂颈内动脉前壁动脉瘤的经验体会。方法:回顾性分析应用支架半释放技术辅助弹簧圈急诊栓塞破裂颈内动脉前壁动脉瘤(11例破裂动脉瘤)的临床资料、栓塞过程以及结果,其中包括3例血疱状动脉瘤。采用支架半释放技术辅助弹簧圈进行栓塞治疗。结果:栓塞术后即时造影显示11个动脉瘤100%栓塞10例,其中的3例血疱状动脉瘤,2例完全栓塞,另1例虽然达到完全栓塞,但因瘤腔内弹簧圈被血流冲离动脉瘤腔,溢入颈内动脉内。95%栓塞1例。11例患者术后24个月内行临床随访,无再次蛛网膜下腔出血,mRS评分全部为0分。仅9例同意行CTA复查,无动脉瘤腔复发。结论:支架半释放技术辅助弹簧圈栓塞动脉瘤虽然操作相对复杂,但能够即时将动脉瘤与载瘤动脉隔离,达到解剖治疗效果。目前适合于出血性颈动脉前壁动脉瘤的急诊治疗。Objective： To evaluate cases of embolization of anterior wall aneurysms of internal carotid artery （ICA） assisted with semi-de- ploying stent coils technique. Methods： A retrospective study were performed. Data included age, sex, Hunt and Hess grade, aneurysm size of eleven patients, procedure of ruptured aneurysm emergent repair assisted with semi-deploying stent coils technique, complications, and modified Rankin score （mRS） at follow-up. Three blood blister aneurysms were among 11 aneurysms. Results： Eleven anterior wall a- neurysms of ICA had been embolized with semi-deploying stent coils technique. Ten anem：csms reached 100% embolization while three blood blister aneurysms reached 100% embolization, though one case had a coil partly protruded into ICA. One aneurysms reached 95% embolization. All patients achieved good outcome （GOS Score less than 2） at discharge. After 24 months, all patients had no re-rupture of a- neurysm, and their mRS were 0 at follow-up. No aneurysm remained in nine patients with CTA inspection. Conclusion： Although semi-de- ploying stent coils technique is complex, it can isolate anemTsm from parent artery. Therefore it can be applied to emergent treatment of ruptured anterior wall aneurysms of ICA.

关 键 词：颈内动脉前壁动脉瘤 颅内支架 栓塞治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]