LVIS支架辅助下颅内动脉瘤非致密栓塞的脑血管造影随访  

Follow-up of cerebral angiography in patients with non-compacted embolization immediately after intracranial aneurysm assisted by low-profile visualized intraluminal support stent

作　　者：丁明祥[1] 黄晓光 谢兵[1] 胡恺 李兵 韩志安[1] DING Ming-xiang;HUANG Xiao-guang;XIE Bing;HU Kai;LI Bing;HAN Zhi-an(Department of Cerebrovascular Intervention,Zhongshan People's Hospital,Zhongshan 528400,Guangdong,CHINA)

机构地区：[1]中山市人民医院脑血管介入科,广东中山528400

出　　处：《海南医学》2020年第22期2958-2960,共3页Hainan Medical Journal

摘　　要：目的脑血管造影随访采用LVIS支架辅助下颅内动脉瘤即刻非致密栓塞患者的瘤腔闭塞情况。方法回顾性分析2016年7月至2019年12月期间中山市人民医院脑血管介入科采用LVIS支架辅助行颅内动脉瘤栓塞,但术后即刻图像为非致密栓塞且能成功完成后续脑血管造影随访的12例患者的资料,采用Raymond分级评价动脉瘤的栓塞效果,对比分析患者术后即刻及随访的相关资料。结果12例患者手术过程均顺利,11例患者采用单支架辅助栓塞,1例患者采用双支架套叠辅助栓塞,共置入13枚支架。术后即刻动脉瘤Raymond分级Ⅱ级3例(25.0%),Ⅲ级9例(75.0%)。12例患者于栓塞术后6~14个月完成脑血管造影随访。其中1例患者因突发肢体偏瘫急诊入院,完善脑血管造影检查提示支架内血栓形成,动脉瘤情况无法评估。其余11例患者随访时动脉瘤Raymond分级Ⅰ级10例,Ⅱ级0例,Ⅲ级1例,瘤腔自行闭塞率为90.9%。结论采用LVIS支架辅助栓塞颅内动脉瘤,即刻非致密栓塞患者后期有较高几率动脉瘤瘤腔自行闭塞,但大型、巨型动脉瘤病例数太少,效果仍需继续研究。Objective To assess the occlusions of cavity by cerebral angiography in patients with non-compacted embolization immediately after intracranial aneurysm assisted by low-profile visualized intraluminal support(LVIS)stent.Methods The clinical data of 12 patients with non-compacted embolization immediately after intracranial aneurysm assisted by LVIS stent in Zhongshan People's Hospital from July 2016 to December 2019 were retrospectively analyzed,and the follow-up of cerebral angiography of the patients were successfully completed.The embolization effect of aneurysms was evaluated according to the Raymond classification,and the relevant data of patients immediately after operation and follow-up were analyzed.Results The operation of 12 patients was successfully completed,including 11 patients with single stent-assisted embolization,and 1 patient with double stent-assisted telescopic embolization,with a total of 13 stents placed.Immediate postoperative radiography showed 3 cases of Raymond gradeⅡ(25.0%),9 cases of Raymond gradeⅢ(75.0%).Twelve patients completed cerebral angiography follow-up of 6-14 months after embolization.One patient was admitted to the hospital due to sudden limb hemiplegia.Emergency cerebral angiography revealed thrombosis in the stent and the aneurysm could not be evaluated.Among the 11 other patients,there were 10 patients of Raymond gradeⅠ,0 patient of Raymond gradeⅡ,and 1 patient of Raymond gradeⅢ,and the self-occlusion rate of the cavity was 90.9%.Conclusion Patients with non-compact embolization immediately after LVIS stent-assisted embolization of intracranial aneurysms have a relatively high probability of self-occlusion of the aneurysm cavity in the later stage,but more study is needed due to the small number of cases of large and giant aneurysms.

关 键 词：颅内动脉瘤 血管内治疗 支架 栓塞 

分 类 号：R739.41[医药卫生—肿瘤]