血管内支架介入治疗颅内宽颈动脉瘤临床效果及并发症分析  

The clinical effects and complications of intravascular stent in the treatment of intracranial wide-necked aneurysms

作　　者：钟剑烽 李斌[1] 唐太昆[1] 邱学才[1] 马孝伟[1] 

机构地区：[1]昆明医科大学附属延安医院神经外科,云南昆明650051

出　　处：《转化医学电子杂志》2016年第4期21-22,共2页E-Journal of Translational Medicine

摘　　要：目的：探讨使用血管内支架结合电解可脱弹簧圈（GDC）治疗颅内宽颈动脉瘤的临床效果及并发症.方法：选取41例经全脑血管造影确诊为宽颈动脉瘤患者作为研究对象,将支架置入载瘤动脉,通过支架的网孔在动脉瘤腔填塞GDC.术后均进行临床随访1-10个月,观察患者治疗效果以及并发症.结果：1例术后意外死亡,30例动脉瘤全部消失,8例大部分消失,2例动脉瘤复发.并发症：发生支架移位5例,其中支架释放后通过支架网眼超选动脉瘤腔时,支架向远端移位1例,但未导致任何严重后果,4例患者取出球囊时支架被球囊所带动而移位.发生血栓性脑梗死3例,颈内动脉一过性痉挛2例,1例弹簧圈末端自动脉瘤腔逸出,无其他明显并发症,患者均恢复良好.结论：血管内支架置入是治疗颅内动脉瘤的新方法,结合GDC是治疗颅内宽颈安全、有效的治疗方法之一.AIM： To study the clincal effects and complications of vascular stent and guglielmi detachable coils（ GDC） in the treatment of intracranial wide-necked aneurysms. METHODS：A total of 41 patients with wide-necked aneurysms confirmed by cerebral angiography were inserted the stent cross aneurysm carotid and filled with GDC through the mesh of the stent in the aneurysm cavity. The effect and complication were observed for 1 to10 months after treatment. RESULTS： 1 patient died after treatment unexpectedly,30 cases had no aneurysm,8 cases lost most part of aneurysm,2 cases showed aneurysm recurrence. Complications： 5 stent migration cases,among them 1 stent mesh stents shifted to the distal when getting through the superselective aneurysm cavity and with no serous side effect. The remaining four stents were driven by balloon when retrieving the stent. Thrombotic cerebral infarction occurred in 3 cases,2 internal carotid artery spasm cases,1 case of coil terminal automatic vein aneurysm cavity escape,with no other complications and good recovery. CONCLUSION： Intravascular stent is a new method for the treatment of intracranial aneurysms,and it is effective and safe for intracranial wide neck combined with GDC.

关 键 词：脑动脉瘤 电解可脱卸弹簧圈 支架 介入治疗 

分 类 号：R739.41[医药卫生—肿瘤]