球囊联合支架辅助弹簧圈栓塞颅内分叉部宽颈动脉瘤  

Balloon combined with stent-assisted steel-coil embolization for the treatment of intracranial wide-necked aneurysms located at artery bifurcation sites

作　　者：刘志华[1] 沈进[1] 赵卫[1] 石潆[1] 

机构地区：[1]昆明医科大学第一附属医院影像科,云南昆明650032

出　　处：《介入放射学杂志》2015年第6期463-466,共4页Journal of Interventional Radiology

摘　　要：目的分析球囊联合支架辅助弹簧圈栓塞术治疗颅内分叉部宽颈动脉瘤的优势。方法回顾性分析2014年1月至4月昆明医科大学第一附属医院采用球囊联合支架辅助弹簧圈栓塞术治疗20例共25枚颅内分叉部宽颈动脉瘤患者的临床资料。20例患者中曾患蛛网膜下腔出血12例,无出血史8例;25枚颅内分叉部宽颈动脉瘤中位于基部动脉未端分叉部14枚,大脑中动脉分叉部8枚,颈内动脉末端分叉部3枚。根据Raymond分级评价介入治疗术后即刻和3个月后三维DSA检查结果,根据改良Rankin量表（m RS）评分评价术后3个月临床疗效。结果球囊联合支架辅助弹簧圈栓塞术后即刻三维DSA检查显示25枚颅内分叉部宽颈动脉瘤中RaymondⅠ级21枚,Ⅱ级2枚,Ⅲ级2枚;术后3个月DSA随访显示RaymondⅠ级20枚,Ⅱ级3枚,Ⅲ级2枚。术后3个月m RS评分显示17例患者0分,1例患者1分,均预后良好;2例患者4~6分,预后不良。结论球囊联合支架辅助弹簧圈栓塞术在颅内分叉部宽颈动脉瘤介入治疗术中具有明显优势。Objective To discuss the advantages of balloon combined with stent-assisted steel-coil embolization in treating intracranial wide-necked aneurysms located at artery bifurcation sites. Methods The clinical data of 20 patients with intracranial wide-necked aneurysms located at artery bifurcation sites（25aneurysms in total）, who were admitted to the First Affiliated Hospital of Kunming Medical University during the period from January 2014 to May 2014 to receive balloon combined with stent-assisted steel-coil embolization treatment, were retrospectively analyzed. Among the 20 patients, 16 had a history of subarachnoid hemorrhage and 4 had no history of subarachnoid hemorrhage. A total of 25 intracranial aneurysms located at artery bifurcation were detected; the locations included basilar terminal bifurcation（n=14）, middle cerebral artery（MCA） bifurcation（n=8） and internal carotid artery（ICA） bifurcation（n=3）.Three dimensional DSA was performed immediately and three months after the treatment, and the manifestations were evaluated according to Raymond classification. The clinical efficacy at three months after the treatment was assessed with the modified Rankin scale（m RS）. Results Three dimensional DSA performed immediately after the balloon combined with stent-assisted steel-coil embolization treatment showed that among the 25 intracranial wide-necked aneurysms located at artery bifurcation 21 belonged to Raymond grade Ⅰ, 2 belonged to Raymond grade Ⅱ and 2 belonged to Raymond grade Ⅲ. Follow-up DSA performed three months after the treatment revealed that 20 aneurysms were Raymond grade Ⅰ, 3 aneurysms were Raymond grade Ⅱ and 2 aneurysms were Raymond grade Ⅲ. Three months after the treatment the m RS scorewas 0 point in 17 patients and one point in one patient, and the prognosis of these patients was good; the m RS score was 4-6 points in 2 patients, and the prognosis of the two patients was poor. Conclusion For the treatment of intracranial wide-necked aneurysms located at a

关 键 词：球囊 支架 弹簧圈 颅内动脉瘤 分叉部 

分 类 号：R743[医药卫生—神经病学与精神病学]