Pipeline栓塞装置在治疗颈内动脉海绵窦段动脉瘤中的应用  

Application of Pipeline embolization device for the treatment of internal carotid cavernous aneurysms

作　　者：李桂林[1] 李静伟[1] 张鸿祺[1] 

机构地区：[1]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国脑血管病杂志》2016年第8期436-441,共6页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨使用带有密网孔血流导向支架的Pipeline栓塞装置（PED）治疗颈内动脉海绵窦段动脉瘤的效果。方法回顾性分析2015年6月至2016年2月使用PED治疗的13例颈内动脉海绵窦段动脉瘤患者的临床资料,其中男4例,女9例,年龄为15~69岁,平均（54±14）岁。对其临床症状和影像学效果进行随访评估。结果对13个海绵窦段动脉瘤,术中共使用14枚PED（1例使用2枚）,其中10例使用PED和弹簧圈栓塞,3例仅使用PED栓塞。术后即刻造影均显示瘤腔内对比剂明显滞留。术后随访3~10个月,患者症状均得到缓解,动脉瘤均闭塞。术后出现并发症1例（支架内急性血栓形成）,经动脉溶栓后恢复出院。结论初步应用PED治疗颈内海绵窦段动脉瘤安全和有效,但仍需要更多样本量和更长时间的随访以进一步验证。Objective To investigate the effect of Pipeline embolization device （PED） with dense mesh flow diversion stents for the treatment of internal carotid cavernous aneurysms. Methods The clinical data of 13 patients with internal carotid cavernous aneurysm treated with PED from June 2015 to February 2016 were analyzed retrospectively. There were 4 men and 9 women; aged 15 -69 years old （mean, 54 ± 14 years）. Their clinical symptoms and imaging effect were evaluated during the follow-up. Results The cavernous aneurysms of 13 patients were treated with 14 PEDs （ I patient used 2 PEDs）. Ten of them were embolized with PEDs and coils, 3 were embolized with PEDs alone, Angiography immediately procedure revealed that the contrast agent in the aneurysm cavity was obviously stranded. They were followed up for 3 to 10 months. All the symptoms were relieved and the aneurysms were occluded. Only 1 patient had a complication （ in-stent acute thrombosis） after procedure. The patient recovered and discharged after arterial thrombolysis. Conclusion The preliminary application of PED for the treatment of internal carotid cavernous aneurysms has shown that PED is safe and effective. However, it still needs more sample size and longer follow-up for further validation.

关 键 词：颅内动脉瘤 海绵窦段动脉瘤 Pipeline栓塞装置 血流导向 

分 类 号：R651.12[医药卫生—外科学]