LVIS支架辅助栓塞治疗颅内后循环动脉瘤的疗效  

Clinical effects of LVIS devices-assisted endovascular treatment on posterior circulation intracranial aneurysms

作　　者：韦成聪[1] 谢昌纪[1] 周志宇[1] 陈杰飞[1] WEI Cheng-cong;XIE Chang-ji;ZHOU Zhi-yu;CHEN Jie-fei(Department of Neurosurgery,National Hospital of Guangxi Zhuang Autonomous Region,Nanning 530001,China)

机构地区：[1]广西壮族自治区民族医院神经外科

出　　处：《中国临床神经外科杂志》2019年第7期406-409,共4页Chinese Journal of Clinical Neurosurgery

基　　金：广西壮族自治区卫生厅自筹经费计划课题(Z2014178)

摘　　要：目的探讨LVIS支架辅助栓塞治疗颅内后循环动脉瘤的安全性及有效性。方法回顾性分析2015年9月至2018年5月采用LVIS支架辅助栓塞治疗的39例(40个动脉瘤)颅内后循环动脉瘤的临床资料。采用单支架27例(单支架组),双支架12例(双支架组)。结果 39例共使用LVIS支架51枚,其中40枚支架释放时一次性完全打开,10枚释放支架后采用导管导丝按摩技术后完全打开,1枚支架打开不完全。单支架组和双支架组围手术期并发症发生率(0%vs. 11.1%)无统计学差异(P>0.05)。术后即刻造影显示:单支架组和双支架组有效栓塞率(92.6%vs. 91.7%)无统计学差异(P>0.05)。术后6个月DSA复查:单支架组和双支架组动脉瘤完全闭塞率(77.7%vs. 75.0%)及复发率(7.4%vs. 8.3%)均无统计学差异(P>0.05)。术后6个月改良Rankin量表评分0分19例,1分15例,2分2例,3分3例。结论 LVIS支架辅助栓塞治疗颅内后循环颅内动脉瘤效果满意,短期影像学随访显示双支架辅助栓塞结果并不优于单支架组。Objective To investigate the effects of low profile visualized intraluminal support(LVIS) stent-assisted endovascular treatment on the posterior circulation intracranial aneurysms and its safety. Methods The clinical data of 39 patients with 40 posterior circulation intracranial aneurysms treated with LVIS stent-assisted coil embolization from September, 2015 to May, 2018 were analyzed retrospectively. According to the number of used stents, the patients were divided into single stent group(n=27) and double stent group(n=12), and the curative effects were compared between both the groups. Results DSA immediately after the embolization showed that the effects of aneurysmal embolization achieved Raymond gradeⅠin 6 patients,Ⅱ in 19 and Ⅲ in 2 of the single sent group and Raymond grade I in 4,Ⅱ in 7 and Ⅲ in 1 of double sent group. The good rate(modified Rankin score 0~2 points) of the prognosis was92.3%(36/39) and the rates of aneurysmal recurrence were 7.4% and 8.3% respectively in the single sent group and double sent group 6 months after the embolization. There was no significant difference in the rates of aneurymal recurrence between both the groups(P>0.05). Conclusions The effects of LVIS stent-assisted endovascular treatment on the posterior circulation intracranial aneurysms is satisfactory. The single stent-assisted embolization is similar to double sent-assisted embolization in the curative effects on the posterior circulation intracranial aneurysms.

关 键 词：颅内动脉瘤 后循环 LVIS支架 预后 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]