Pipeline Flex血流导向装置治疗颅内动脉瘤的初步临床经验  

Preliminary experience of Pipeline Flex device in the treatment of intracranial aneurysms

作　　者：王凯[1] 成晓江[1] 卡合尔曼·卡德尔[1] 买买提力·艾沙[1] Wang Kai;Cheng Xiaojiang;Kaheerman· Kadeer;Maimaitili· Aisha(Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院,乌鲁木齐830054

出　　处：《中华神经外科杂志》2019年第6期547-551,共5页Chinese Journal of Neurosurgery

基　　金："十三五"国家重点研发计划(2016YFC1300800).

摘　　要：目的探讨Pipeline Flex血流导向装置(PED Flex)治疗颅内动脉瘤的初步临床经验。方法回顾性分析2018年1至11月新疆医科大学第一附属医院神经外科应用PED Flex治疗的23例(23个动脉瘤)颅内动脉瘤患者的临床资料。其中破裂动脉瘤4例,未破裂动脉瘤19例;前循环动脉瘤20例,后循环动脉瘤3例;动脉瘤最大径为7.2~30.2 mm,平均(15.7±6.3)mm;囊性动脉瘤19例,梭形动脉瘤2例,夹层动脉瘤2例。弹簧圈辅助治疗13例。总结治疗经验,观察临床疗效。结果21例(91%)成功置入PED Flex支架,支架释放后贴壁良好,均未采用球囊行后扩张。未能成功置入的2例患者,1例因载瘤动脉近端血管严重迂曲,1例因术中出血(术后5 d死亡)。1例术前动脉瘤破裂的患者术后发生梗阻性脑积水,其余患者均无围手术期并发症。术后6个月16例患者行数字减影血管造影随访,动脉瘤均闭塞良好,无复发,载瘤动脉通畅。结论PED Flex治疗颅内动脉瘤的初步治疗结果显示,置入成功率较高,并发症相对较少;短期疗效较好,远期疗效需要进一步随访。Objective To explore the clinical application and preliminary experience of Pipeline Flex device (PED Flex) in the treatment of intracranial aneurysms. MethodsThe data of 23 patients with 23 intracranial aneurysms treated by Pipeline Flex device at Neurosurgery Department of the First Affiliated Hospital of Xinjiang Medical University from January to November 2018 were retrospectively analyzed. Among them,4 were ruptured aneurysms and 19 were unruptured aneurysms. There were 20 anterior circulation aneurysms and 3 posterior circulation aneurysms. The size of aneurysm was 7.2-30.2 mm,with an average of 15.7±6.3 mm. There were 19 cases of cystic aneurysm,2 cases of fusiform aneurysm and 2 cases of dissecting aneurysm. Among all cases,13 were treated with adjuvant coils. ResultsPED Flex stent was successfully implanted in 21 (91%) cases. The stents adhered well after release and no balloon was used for post-dilatation. PED failed to be placed in 2 cases including 1 with severe distortion of the proximal vessel of the parent artery and the other with intraoperative bleeding resulting in death at 5 days post operation. One patient had obstructive hydrocephalus after operation due to rupture of aneurysm before operation. The remaining patients had no perioperative complications. Six months after operation,16 patients were followed up by digital subtraction angiography (DSA). All the aneurysms were occluded well without recurrence and the parent artery was unobstructed. ConclusionsThe preliminary results of PED Flex in the treatment of intracranial aneurysms show that the success rate of implantation seems higher and the complications are relatively less. The short-term effect is better and long-term effect needs further follow-up.

关 键 词：颅内动脉瘤 栓塞 治疗性 血流导向装置 

分 类 号：R743[医药卫生—神经病学与精神病学]