LVIS支架在颈内动脉海绵窦段打开不良与血管弯曲的关系  

Relationship between unsatisfactory release of LVIS stent and vascular tortuosity in the cavernous segment of internal carotid artery

作　　者：肖贾伟 赵瑞[1] 李嘉楠[1] 郑乾[1] 许奕[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 [2]河南省平煤神马医疗集团总医院放射介入科,467000

出　　处：《中国脑血管病杂志》2017年第3期118-121,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨颈内动脉海绵窦水平段血管弯曲度和弯曲半径对新型编织型支架(LVIS支架)打开情况的影响。方法回顾性连续纳入2015年12月至2016年1月第二军医大学附属长海医院神经外科应用新型LVIS支架治疗且支架近端释放于海绵窦段水平段的31例宽颈动脉瘤患者,根据支架是否在第1次释放后,支架完全贴壁分为两组,打开良好组23例,打开不良组8例。比较两组血管弯曲度和弯曲半径的差异。结果打开良好组与打开不良组的血管弯曲度平均值分别为118°±23°和147°±19°,差异有统计学意义(P=0.028);两组血管弯曲半径平均值分别为(3.4±0.7)mm和(2.8±0.7)mm,差异有统计学意义(P=0.042)。支架打开不良组的平均血管弯曲度更大,平均血管弯曲半径更小。结论血管弯曲度大及血管弯曲半径小与LVIS支架释放过程中打开不良有关。支架置入前对血管弯曲度的评估有助于指导支架释放技术。Objective To investigate the effect of vascular tortuosity and bending radius on the new type knitting stents （ LVIS stent ） releasing on the cavernous sinus segment of internal carotid artery. Methods From December 2015 to January 2016,31 consecutive patients with wide-necked aneurysm treated with LVIS stents and the proximal end of the stent released in the cavernous segment at the Department of Neurosurgery, Changhai Hospital, the Second Military Medical University were enrolled. According to whether the stents completely adhered to the walls or not after the first release ,they were divided into two groups ： a satisfactorily release group （ n = 23 ） or an unsatisfactofily release group （ n=8 ）. The differences of vascular tortuosity and bending radius of the 2 groups were compared. Results The vascular tortuosities of the satisfactorily release group and the unsatisfactorily release group were 118°± 23° and 147° ± 19° respectively. There was significant difference （P =0.028）. The vascular bending radii were 3.4±0.7 mm and 2.8 ± 0.7 mm respectively. There was significant difference （ P = O. 042 ）. The mean vascular tortuosity was larger and the mean vascular bending radius was smaller in the unsatisfactorily release group. Conclusions The greater the vascular tortuosity, the smaller the vascular bending radius may be connected with the unsatisfactorily release in the LVIS stent. The evaluation of vascular tortuosity is conductive to the guidance of the stent release technique before stent implantation.

关 键 词：颅内宽颈动脉瘤 LVIS编织支架 打开不良 弯曲度 弯曲半径 

分 类 号：R651.12[医药卫生—外科学]