支架结合弹簧圈治疗8例颈内动脉前壁动脉瘤——“铆钉”技术的运用  

Embolization of internal carotid artery anterior wall aneurysms by stenting and coiling:8 cases with “rivets” technology

作　　者：蒋永祥[1] 吉翔 程远[1] 陈维福[1] 马颖[1] JIANG Yongxiang;JI Xiang;CHENG Yuan;CHEN Weifu;MA Ying(Department of Neurosurgery,the Second Affiliated Hospital of Chongqing Medical University,Chongqing,400010,China)

机构地区：[1]重庆医科大学附属第二医院神经外科,重庆400010

出　　处：《第三军医大学学报》2019年第4期360-365,共6页Journal of Third Military Medical University

摘　　要：目的探讨支架结合弹簧圈的"铆钉"技术在血管内治疗颈内动脉前壁动脉瘤中的应用及其有效性、安全性。方法回顾性分析本科2010年1月至2018年5月收治的8例采用"铆钉"技术进行血管内治疗的颈内动脉前壁动脉瘤患者的临床资料及其术后脑血管造影和随访结果。结果 8例患者均在术中安全栓塞动脉瘤,未发生术中破裂出血。1例患者在术后1周、3个月、6个月复查DSA均可见动脉瘤颈少量残留,但是瘤颈弹簧圈形态稳定,故予以继续随访;而其余7例患者在术后6个月复查DSA示动脉瘤颈血管内膜修复良好,动脉瘤治愈。结论通过"铆钉"技术主动增强动脉瘤颈处弹簧圈的抗冲击能力,再结合支架的血流导向作用,能够安全、有效地治疗此类极易破裂的动脉瘤。Objective To investigate the application,safety and effectiveness of "rivets"technique in endovascular therapy of internal carotid artery anterior wall anuerysms.Methods A retrospective study was carried on 8 patients suffered from aneurysm in anterior wall of the internal carotid artery and treated by endovascular therapy with rivets technique in our department from January 2010 to May 2018.Their clinical data,postoperative cerebral angiography,and clinical outcomes by follow-up digital subtraction angiography( DSA) were collected and analyzed.Results All aneurysms in the 8 patients were safely and successfully embolized during the operation,and no intraoperative aneurysm rupture happened.One patient was found having a little residual of aneurysm neck in the DSA results in 1 week,3 months and 6 months after the operation,and this patient was followed up further since the coil was stable in form.DSA reexamination in 6months after operation showed the other 7 patients had well repaired carotid artery intima,indicating that the aneurysm was cured completely.Conclusion The "riveting"technology can enhance the anti-impact ability of the coil at the neck of aneurysm.Combined with the stent guiding the blood flow,the technology can safely and effectively treat these easily ruptured aneurysms.

关 键 词：颅内动脉瘤 颈内动脉前壁 血管内治疗 假性动脉瘤 弹簧圈 Lvis支架 

分 类 号：R615[医药卫生—外科学] R653[医药卫生—临床医学]