Solitaire单支架辅助下颅内多发宽颈动脉瘤栓塞术  

Embolization of multiple wide-necked intracranial aneurysms assisted with single Solitaire stent

作　　者：王东海[1] 吴红星[2] 刘青林[1] 申杰[1] 邓林[1] 王云彦[1] 苏万东[1] 李刚[1] 李新钢[1] 

机构地区：[1]山东大学齐鲁医院神经外科,济南250012 [2] 新疆自治区人民医院神经外科

出　　处：《中华神经外科杂志》2015年第6期548-551,共4页Chinese Journal of Neurosurgery

基　　金：泰山学者建设工作专项经费（ts20110814）;山东省科技发展计划（2014GGH218107）;山东大学齐鲁医院临床新技术（201301）

摘　　要：目的 探讨应用单一Solitaire支架辅助栓塞颅内同一动脉多发宽颈动脉瘤的方法,为颅内多发宽颈动脉瘤的微创治疗提供临床支持.方法 收集2011年6月至2014年2月山东大学齐鲁医院神经外科和新疆自治区人民医院神经外科收治的单一载瘤动脉多发动脉瘤患者中15例宽颈动脉瘤患者,采取Seldinger技术股动脉置鞘,根据动脉瘤的瘤颈、动脉瘤之间的距离及载瘤动脉管径选择不同规格的Solitaire支架,采取预置支架导管和栓塞微导管的方法,单支架覆盖同一载瘤动脉的2个宽颈动脉瘤,支架辅助下微弹簧圈栓塞动脉瘤.结果 本组共15例患者,其中前循环8例,后循环7例.术中所有病例的支架均到位满意,动脉瘤完全栓塞11例,3例瘤颈部少许残留,1例术中微弹簧圈部分自支架内脱出,1例术中发生血栓给予溶栓处理后即时再通.6个月后随访,12例患者行头颅CTA或DSA检查,瘤颈部复发2例,再次栓塞治疗1例.结论 应用Solitaire单支架辅助微弹簧圈栓塞治疗颅内同一载瘤动脉多发宽颈动脉瘤,具有微创、操作便捷、疗效肯定的优点,为颅内多发宽颈动脉瘤的微创治疗提供了一种有效的选择.Objective To investigate the technical methods of embolization of multiple wide-necked intracranial aneurysms on the same artery by using single Solitaire stent assistance in order to provide the clinical support for the minimally invasive treatment of intracranial multiple wide-necked aneurysms.Methods In patients with multiple aneurysm on a single parent artery,15 patients with wide-necked aneurysms admitted to the Department of Neurosurgery,Qilu Hospital of Shandong University and the Department of Neurosurgery,People＆#39; s Hospital of Xinjiang Uygur Autonomous Region from June 2011 to February 2014.Seldinger technique was used for the placement of needle sheaths in femoral artery,the different specifications of Solitaire stents were selected according to the aneurysm neck,distance between the two aneurysms,and the diameter of parent artery.Using the methods of preset stent catheters and embolizing micro-catheters,a single stent covered 2 wide-necked aneurysms on the same parent artery.Microcoils were used to embolize the aneurysms under the assistance of stents.Results A total of 15 patients with widenecked intracranial aneurysms in this group,including 8 in anterior circulation and 7 in posterior circulation.Stent implantation was satisfactory in all patients during the procedure.The aneurysms of 11 patients were embolized completely,3 had a little residue on aneurysm necks,a part of microcoil in 1 case escaped from a stent during the procedure,1 occurred thrombosis during the procedure and it was recanalized immediately after thrombolytic treatment.The patients were followed up after 6 months,12 performed head CTA or DSA examinations,2 relapsed on the neck,and 1 was reembolized.Conclusion Using single Solitaire stentassisted microcoil embolization of the multiple wide-necked intracranial aneurysms in the same parent artery has the advantages of minimally invasive,easy to operate,and curative effect.It provides an effective option for the minimally invasive treatment of multiple intracranial wide-necked a

关 键 词：颅内动脉瘤 血管内治疗 支架 弹簧圈 

分 类 号：R651.1[医药卫生—外科学]