套叠LVIS支架结合弹簧圈栓塞治疗颈内动脉床突上段夹层动脉瘤  

Overlapping LVIS stents combined with coil embolization for dissecting aneurysms of supraclinoid segment of internal carotid artery

作　　者：张海林[1] 周保元 谢宗志 唐博[1] 任小鲁 任军[1] 孙守元 刘吉星[1] ZHANG Hai-lin;ZHOU Bao-yuan;XIE Zong-zhi;TANG Bo;REN Xiao-lu;REN Jun;SUN Shou-yuan;LIU Ji-xing(Department of Neurosurgery,Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院神经外科,兰州730030

出　　处：《中国临床神经外科杂志》2020年第11期737-739,共3页Chinese Journal of Clinical Neurosurgery

基　　金：兰州市科技计划项目(2017-4-87)。

摘　　要：目的探讨套叠LVIS支架结合弹簧圈栓塞治疗颈内动脉床突上段夹层动脉瘤的疗效。方法回顾性分析2014年1月至2019年12月采用套叠LVIS支架结合弹簧圈栓塞治疗的43例颈内动脉床突上段夹层动脉瘤的临床资料。结果双支架套叠40例,三支架2例,四支架1例;技术成功率100%。术后即刻造影示动脉瘤致密栓塞28例,瘤颈部残余9例,瘤体残余6例。出院时改良Rankin量表评分0~2分33例,3分5例,4~5分3例,6分2例。37例影像学随访6~26个月,动脉瘤不显影31例,改善2例,复发3例,载瘤动脉闭塞1例。结论套叠LVIS支架辅助弹簧圈栓塞治疗颈内动脉床突上段夹层动脉瘤是一种有效的方法。Objective To explore the clinical efficacy of overlapping LVIS stents combined with coil embolization for the patients with dissecting aneurysms of supraclinoid segment of internal carotid artery(DA-SS-ICA).Methods The clinical data of 43 patients with DA-SS-ICA who received overlapping LVIS stents combined with coil embolization from January 2014 to December 2019 were anapyzed retrospectively.Results Of 43 patients,40 patients were treated with double LVIS stents,2 with triple LVIS stents and 1 with four LVIS stents.The technical success rate was 100%.The immediate postoperative angiography showed that total occlusion of aneurysm was achieved in 28 patients,residual neck in 9 and residual aneurysm in 6.According to the modified Rankin scale(mRS)score at discharge,33 patients had mRS score of 0~2,5 of 3,3 of 4~5,and 2 of 6.The results of imaging folow-up of 37 patients(range,6~26 months)showed that the aneurysms were not seen in 31 patients,improved in 2,and recurred in 3,and the aneurysmal artery occlusion was seen in 1 patienst.Conclusions The overlapping LVIS stents combined with coil embolization for patients with DA-SSICA is feasible and safe.Using more stents can further reduce the risk of recurrence.

关 键 词：颈内动脉床突上段夹层动脉瘤 血管内治疗 LVIS支架 弹簧圈 支架套叠技术 疗效 

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]