Enterprise联合LVIS支架重叠辅助栓塞治疗椎动脉颅内段夹层动脉瘤  

Overlapping Enterprise and LVIS stents for the treatment of intracranial vertebral dissecting aneurysms

作　　者：亓敬涛[1] 张广[1] 徐善才[1] 季智勇[1] 王春雷[1] 史怀璋[1] Qi Jingtao;Zhang Guang;Xu Shancai;Ji Zhiyong;Wang Chunlei;Shi Huaizhang(Department of Neurosurgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,150001

出　　处：《中华神经外科杂志》2018年第8期796-800,共5页Chinese Journal of Neurosurgery

摘　　要：目的 评估应用Enterprise联合LVIS支架重叠辅助栓塞技术治疗椎动脉颅内段夹层动脉瘤的有效性和安全性.方法 回顾性连续纳入2015年1月至2017年6月哈尔滨医科大学附属第一医院神经外科收治的22例椎动脉颅内段夹层动脉瘤患者,所有患者均接受Enterprise联合LVIS支架重叠辅助弹簧圈栓塞治疗.以夹层动脉瘤的栓塞程度评估手术效果,采用改良Rankin量表评分（mRS）评估患者的预后.以围手术期的并发症和随访期内新发或再发责任血管卒中事件的发生情况评估手术的安全性.结果 术后即刻完全栓塞4例（18.2％）,次全栓塞7例（31.8％）,部分栓塞11例（50.0％）.围手术期1例（4.5％）发生动脉瘤再次破裂出血并死亡.21例患者术后随访4～21个月,平均（9.4±4.8）个月.随访患者中无任何并发症发生,mRS评分均为0分.10例行影像学随访,其中9例达到完全栓塞,1例载瘤动脉闭塞.结论 应用Enterprise联合LVIS支架重叠辅助弹簧圈栓塞是一种安全、有效的治疗椎动脉颅内段夹层动脉瘤的方法.Objective To evaluate the efficacy and safety of overlapping Enterprise and LVIS stentsassisted coiling for the treatment of vertebral dissecting aneurysms.Methods From January 2015 to June 2017,22 patients with vertebral dissecting anemysms were treated with overlapping Enterprise and LVIS stents-assisted coiling therapy at Department of Neurosurgery,the First Affiliated Hospital of Harbin Medical University and consecutively enrolled into this study.The clinical data were retrospectively evaluated.The degree of coiling was assessed to determine the efficacy of treatment.The incidence of new or recurrent stroke due to lesioned vessel was used to assess the safety.Patients＇ outcomes were evaluated based on modified Rankin Scale （mRS）.Results Complete occlusion was achieved in 4 （18.2％） patients,nearly occlusion in 7 （31.8％） and partial occlusion in 11 （50.0％）.One （4.5％） patient died during peri-procedural period due to re-rupture.The follow-up periods ranged from 4 to 21 months with an average of 9.4 ±4.8 months.No complications were seen in other patients with mRS of 0.Imaging follow-up was conducted in 10 patients post procedure.Complete occlusion was achieved in 9 patients and parent artery was occluded in 1.Conclusion Overlapping Enterprise and LVIS stents-assisted coiling may be an effective and safe therapy for vertebral dissecting aneurysms.

关 键 词：颅内动脉瘤 动脉瘤 夹层 椎动脉 血管内操作 治疗结果 

分 类 号：R651.12[医药卫生—外科学]