LVIS支架辅助弹簧圈栓塞在颅内宽颈动脉瘤的应用  

Application of stent-assisted coil embolization in wide-necked intracranial aneurysms

作　　者：周磊[1] 聂庆彬[2] 杜世伟[3] 徐祎[2] 成思[2] 李冬梅 毛更生[1] Zhou Lei Nie Qingbin Du Shiwei Xu Yi Cheng Si Li Dongmei Mao Gengsheng(Clinical College, General Hospital of Chinese Armed Police Forces, Anhui Medical University, Hefei, Anhui 230032, China Department of Neurovascular Surgery, General Hospital of Chinese Armed Police Forces, Beijing 100039, China Department ofNeurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China)

机构地区：[1]安徽医科大学武警总医院临床学院,合肥230032 [2]中国武警总医院神经血管外科,北京100039 [3]首都医科大学宣武医院神经外科,北京100053

出　　处：《中国微侵袭神经外科杂志》2017年第5期216-219,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨LVIS支架辅助弹簧圈栓塞在颅内宽颈动脉瘤的安全性及短期有效性。方法回顾性分析使用LVIS支架辅助栓塞治疗的31例(共32个)颅内宽颈动脉瘤。根据Raymond分级、改良Rankin量表(m RS)评分及影像学随访结果等评估临床应用价值。结果共放置LVIS支架34枚,均成功释放,其中LVIS支架20枚,LVIS Jr支架14枚。术中动脉瘤破裂2例,发生支架远端血栓2例,支架打开不良1例。在术后即刻造影中发现,动脉瘤完全栓塞者29个,瘤颈残留2个,瘤腔残留1个。所有病人术后随访3~12个月,未发现动脉瘤再破裂出血。结论 LVIS支架辅助弹簧圈栓塞颅内宽颈动脉瘤可行、安全,并且短期有效,但由于随访时间短,需要进一步研究来评价LVIS支架的长期有效性。Objective To investigate the safety and short-term efficacy of LVIS （low profile visualized intraluminal support） stent-assisted coil embolization in wide-necked intracranial aneurysms. Methods The clinical data of 31 patients with 32 wide-necked intracranial aneurysms undergoing LVIS stent-assisted coil embolization were analyzed retrospectively. The clinical application was valued by Raymond classification, the modified Rankin scale （mRS） and imaging follow-up results. Results The 34 LVIS stems, including 20 LVIS stents and 14 LVIS Jr stents, were successfully inserted and released. During the procedure, aneurysm rupture occurred in 2 cases, stent distal thrombosis in 2 and stent open undesirable in 1. Angiography was performed immediately after embolization, showing complete occlusion in 29 aneurysms, residual aneurysm neck in 2 and residual aneurysm in 1. The patients were followed up for 3-12 months, no bleeding due to aneurysm rupture. Conclusions LVIS stent-assisted coil embolization is safe and short-term efficacious for wide-necked intracranial aneurysms, but need longer-term follow-ups to evaluate LVIS stent long-term efficacy.

关 键 词：颅内动脉瘤 宽颈 血管内治疗 LVIS支架 弹簧圈 

分 类 号：R651.12[医药卫生—外科学]