Solitaire AB支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的临床研究  

Clinical study of solitaire AB stent assisted with coil embolization therapy in the treatment of wide-necked intracranial aneurysms

作　　者：徐保庆 曹春光[1] 谢方民[1] 宋思新[1] XU Bao-qing;CAO Chun-guang;XIE Fang-min;SONG Si-xin(Dept.of Neurosurgery,Affiliated Hospital of Taishan Medicine Univercity,Taian 271000,China)

机构地区：[1]泰山医学院附属医院神经外科,山东泰安271000

出　　处：《泰山医学院学报》2018年第2期156-159,共4页Journal of Taishan Medical College

摘　　要：目的观察Solitaire AB支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的临床效果及手术安全性。方法选取我院2014年1月—2017年1月收治入院的应用Solitaire AB支架辅助弹簧圈栓塞治疗的颅内宽颈动脉瘤患者46例。围术期给予抗凝及抗血小板治疗,术后3~6个月复查脑血管造影,评价手术效果及术后并发症。结果 46例(49枚)颅内宽颈动脉瘤患者行Solitaire AB支架辅助弹簧圈栓塞治疗,所有支架均成功释放。其中41枚完全致密填塞(83.67%),8枚瘤颈少量残留(16.33%)。术中出现并发症者6例(13.04%),其中血管痉挛者3例(6.52%),血栓形成2例(3.33%),动脉瘤出血者1例(1.67%),无支架移位。所有患者均获临床随访及相关影像学随访,随访时间3~12个月。其中29例术后行脑血管造影复查,支架未见变形。23例致密栓塞的患者动脉瘤未再通。6例次全栓塞患者4例瘤颈消失,2例未见明显变化。格拉斯预后评估:5分31例(67.39%),4分11例(23.91%),3分4例(8.70%)。结论 Solitaire AB支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤效果确切,手术安全性高。Objective To explore the clinical efficiency and safety of solitaire AB stent assisted with coil embolization therapy in the treatment of wide-necked intracranial aneurysms.Methods A total of 46 patients with wide-necked intracranial aneurysms who were admitted in our hospital and given the treatment of stent combined with coil embolization technique from January 2014 to January 2017 were selected.The patients were given the treatment of anti-coagulation and antiplatelet during perioperative period.Cerebral angiography was re-examined 3~6 months after the surgery,embolization effect and complications was evaluated.Results 46 patients(49 pieces)with wide-necked intracranial aneurysms were treated with solitaire AB stent assisted with coil embolization therapy in this study,All stents were successfully released.Total occlusion was achieved in 41 pieces,risidual neck in 8 pieces.The complications of surgery included 6 patients,the vasospasm in 3 patients,the thrombosis in 2 patient,the rupture of aneurysms in 1 patients,no stent displacement.We got the data of clinical follow-up and radiographic follow-up in all cases for 3~12 months.Cerebral angiography was conducted in 29 cases.All stents were not deformation,and no recanalization occured 23 patients with dense embolization of aneurysm.Four patient's residual aneurysm neck disappeared and two got no change in six patients with subtotal embolization of aneurysm.GOS scale was applied for evaluation.31 patients were scored 0,11 were scored 4 and 4 was scored 3.Conclusion Solitaire AB stent assisted with coil embolization technique in the treatment of wide-necked intracranial aneurysms is efficient and safe.

关 键 词：宽颈动脉瘤 SOLITAIRE AB支架 弹簧圈栓塞 

分 类 号：R289[医药卫生—方剂学]