新型机械解脱弹簧圈栓塞颅内动脉瘤的初步经验  

Initial experience in embolizing intracranial aneurysms with new mechanical detachable coils(Presgo?)

作　　者：左乔[1] 许奕[1] 洪波[1] 刘建民[1] 黄清海[1] 

机构地区：[1]第二军医大学附属长海医院神经外科,上海200433

出　　处：《中国临床神经外科杂志》2017年第3期165-167,200,共4页Chinese Journal of Clinical Neurosurgery

基　　金：国家重点研发项目(2016YFC1300700);上海市科委"科技创新行动"产学研医(13DZ1941300);上海市科委"科技创新行动"科技支撑(12441900800)

摘　　要：目的初步评价使用国产Presgo?机械解脱弹簧圈栓塞颅内动脉瘤的安全性和有效性。方法 2011年8月至2012年9月前瞻性收治颅内动脉瘤15例,根据患者意愿分为观察组(7例,7个动脉瘤)和对照组(8例,9个动脉瘤);观察组使用Presgo?机械解脱弹簧圈,对照组使用国产Jasper电解脱弹簧圈。观察组随访169~934 d,中位随访时间为303 d;对照组随访91~411 d,中位随访时间为235 d。结果两组弹簧圈填塞技术成功率均为100%;观察组弹簧圈解脱时间[5.0 s(5.0~8.0 s)]较对照组[45.0 s(38.0~47.3 s)]显著缩短(P<0.05)。观察组术后即刻RaymondⅠ级栓塞2个,Ⅲ级栓塞5个;对照组Ⅱ级栓塞3个,Ⅲ级6个;两组无明显差别(P>0.05)。观察组发生手术相关不良事件2例,对照组为1例;两组差异无统计学意义(P>0.05)。术后6个月,观察组m RS评分0~1分6例,对照组为8例;两组无统计学差异(P>0.05)。结论相比国产Jasper电解脱弹簧圈,新型国产Presgo?机械解脱弹簧圈具有更好的解脱性能,其安全性和有效性与Jasper弹簧圈相仿;但本研究临床样本量小,Presgo?弹簧圈临床使用的安全性和有效性尚需进一步大样本临床验证和长期随访评价。Abstract：Objective To analyze the safety of domestic-made Presgo？ mechanical detachable coil and its curative effect on intracranial aneurysms. Methods Of 16 patients with intracranial aneurysms, 7 received endovascular embolization of the aneurysms with Presgo？ coils and 9 with domestic-made Jasper electronic detachable coils from August, 2011 to September, 2012 in the single center. The detachment function, embolization result, the rate of procedure-related adverse event occurrence rate and modified Rankin Scale （mRS） scores were compared between the two groups. Results The success rates of embolization with two types of coils were both 100%; The median detachment time of Presgo？ coil was 5.0 s, which was significantly shorter than that of Jasper coil （45.0 s, P〈0.001）. There was insignificant difference in the curative effects on the aneurysms between the two groups 6 months after the embolization （P=0.649）. No aneurysms recurred in both the groups. There were insignificant differences in the occurrence rates of the procedure-related adverse events and the prognoses between both the groups （P〉0.05）. Conclusions Presgo？ mechanical detachable coil can be detached more quickly compared to Jasper electronic detachable coil. Presgo？ mechanical detachable coil is similar to Jasper electronic detachable coil in the safety and occluding effect on the aneurysms. But the sample size in this study is very small, and it is necessary to for the clinical safety and efficacy of Presgo？ coils be studied further with larger samples and long-term follow-up.

关 键 词：颅内动脉瘤 栓塞治疗 Presgo机械解脱弹簧圈 Jasper电解脱弹簧圈 安全性 有效性 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]