Willis覆膜支架治疗颅内段颈内动脉病变临床应用  

Clinical application of Willis covered stent implantation in treating vascular diseases located at the intracranial segment of the internal carotid artery

作　　者：王武[1] 程英升[1] 李明华[2] 顾斌贤[2] 

机构地区：[1]苏州大学医学部,215123 [2]上海交通大学附属第六人民医院介入影像科

出　　处：《介入放射学杂志》2016年第3期185-188,共4页Journal of Interventional Radiology

基　　金：国家自然科学基金(81201199)

摘　　要：目的 评价Willis覆膜支架治疗颅内段颈内动脉病变的效果。方法 回顾性分析2013年4月至2015年4月采用Willis覆膜支架治疗的201例颅内段颈内动脉病变患者。术后3-6个月随访复查DSA和临床观察结果。结果 Willis覆膜支架成功治疗198例颅内段颈内动脉病变,其中囊性动脉瘤88例,外伤性动脉瘤19例,假性动脉瘤35例,外伤性颈动脉海绵窦瘘56例,技术成功率达到98.5%。Willis覆膜支架释放部位依次为颈内动脉C7段9例,C6段28例,C5段32例,C4段110例,C3段19例;支架释放后即刻DSA显示病变完全不显影163例,内漏35例,经球囊后扩或再植入支架治疗后病变完全不显影33例（其中2例闭塞载瘤动脉）,2例仍存在内漏。术中发生支架源性血管破裂出血5例,术中成功止血4例;术后再出血1例,死亡2例。术后3-6个月随访复查DSA显示载瘤动脉通畅189例,轻度狭窄5例;病变完全不显影196例。临床随访3-20个月,存活患者无新发神经系统体征。结论 Willis覆膜支架能够安全有效地治疗颅内段颈内动脉病变,但需要更远期随访。Objective To evaluate the efficacy of Willis covered stent implantation in treating the vascular diseases located at the intracranial segment of the internal carotid artery. Methods The clinical data of 201 patients with the vascular diseases located at the intracranial segment of the internal carotid artery, who were admitted to authors＇ hospital during the period from April 2013 to April 2015 to receive Willis covered stent implantation, were retrospectively analyzed. Follow-up observation and DSA examination were conducted within 3-6 months after the treatment. Results The vascular diseases located at the intracranial segment of the internal carotid artery were successfully treated in 198 patients, the technical success rate was 98.5%. Pathologically, the 198 lesions included saccular aneurysm （n=88）, traumatic aneurysm （n=19）,pseudoaneurysm （n=35） and traumatic carotid cavernous sinus fistula （n=56）. The release sites of Willis covered stent were C7 （n=9）, C6 （n=28）, C5 （n=32）, C4 （n=110） and C3 （n=19） segment of internal carotid artery. DSA performed immediately after the stent deployment revealed that complete occlusion of the aneurysm was achieved in 163 patients, and endoleak was observed in 35 patients. Of the 35 patients, after balloon dilatation or second time stent implantation the aneurysm was completely obstructed in 33, the occlusion of the parent artery was seen in 2 and the endoleak remained in 2. During the operation, bleeding due to stent-related vascular rupture occurred in 5 patients and after proper management successful hemostasis was obtained in 4 patients. One patient developed postoperative re-bleeding and 2 patients died. Postoperative DSA examination indicated that the parent artery was unobstructed in 189 patients and was slight narrowed in 5 patients; and in 196 patients the aneurysm was completely occluded. The survival patients were followed up for 3-20 months and no newly-developed neurological signs were observed. Coneluslon For the treatment

关 键 词：Willis覆膜支架 颅内段颈内动脉病变 血管内治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]