Neuroform EZ支架辅助弹簧圈栓塞治疗颈内动脉眼动脉段动脉瘤中远期安全性和有效性分析  

Neuroform EZ stent-assisted coil embolization for ophthalmic segment aneurysms of internal carotid artery: clinical analysis of mid-long term safety and efficacy

作　　者：倪恒 刘圣[1] 赵林波[1] 贾振宇[1] 曹月洲[1] 施海彬[1] NI Heng;LIU Sheng;ZHAO Linbo;JIA Zhenyu;CAO Yuezhou;SHI Haibin(Department of Interventional Radiology,First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210029,China)

机构地区：[1]南京医科大学第一附属医院介入放射科,210029

出　　处：《介入放射学杂志》2021年第6期537-541,共5页Journal of Interventional Radiology

摘　　要：目的评价Neuroform EZ支架辅助弹簧圈栓塞治疗颈内动脉眼动脉段动脉瘤的中远期安全性和有效性。方法回顾性分析2015年4月至2018年12月在南京医科大学第一附属医院接受Neuroform EZ支架辅助弹簧圈栓塞治疗的连续104例颈内动脉眼动脉段动脉瘤患者临床和影像学资料。重点分析动脉瘤特征、术后即刻和进展性闭塞率、围手术期并发症及临床随访结果。结果共104例患者116枚眼动脉段动脉瘤接受治疗,其中16例动脉瘤性蛛网膜下腔出血。根据眼动脉段动脉瘤Krisht分型,上侧型36枚,后侧型32枚,内侧型41枚,外侧型7枚。支架辅助弹簧圈填塞治疗均获成功。手术并发症发生率为2.9%,均为小血栓栓塞事件。术后即刻造影显示动脉瘤完全闭塞60枚(51.7%),近全闭塞54枚(46.6%),部分闭塞2枚(1.7%)。89例患者93枚动脉瘤接受平均(7.6±5.4)个月造影随访,首次随访造影显示完全闭塞率进展至92.5%(86枚),未见迟发性支架内狭窄。动脉瘤复发3枚(3.2%),均再次接受弹簧圈栓塞后达到完全闭塞。96例(92.3%)患者临床随访平均(18.5±11.2)个月,其中95例(99.0%)改良Rankin量表(mRS)评分为0~2分,远期预后良好。结论 Neuroform EZ支架辅助弹簧圈栓塞治疗颈内动脉眼动脉段动脉瘤安全有效,中远期随访中可提供更稳定闭塞率,且未见支架内再狭窄。Objective To evaluate the clinical mid-long term safety and efficacy of Neuroform EZ stent-assisted coil embolization in treating ophthalmic segment aneurysms of internal carotid artery. Methods The clinical data and imaging materials of 104 consecutive patients with ophthalmic segment aneurysms of internal carotid artery, who were admitted to the First Affiliated Hospital of Nanjing Medical University of China during the period from April 2015 to December 2018 to receive Neuroform EZ stent-assisted coil embolization therapy, were retrospectively analyzed. The clinical analysis was focused on the characteristics of aneurysms, the postoperative immediate and follow-up occlusion rates, the perioperative complications, and clinical follow-up outcomes. Results A total of 116 aneurysms were detected in the 104 patients. Aneurysmal subarachnoid hemorrhage was seen in 16 patients. Based on Krisht classification of ophthalmic segment aneurysms, upward type was observed in 36, backward type in 32, medial type in 41 and lateral type in 7 aneurysms. Successful Neuroform EZ stent-assisted coil embolization was accomplished for all aneurysms. The incidence of surgical complications was 2.9%, all of which were minor thromboembolic events. Angiography performed immediately after treatment demonstrated that complete occlusion was achieved in 60(51.7%),subtotal occlusion in 54(46.6%), and partial occlusion in two(1.7%) aneurysms. Eighty-nine patients(93 aneurysms in total) were followed up with angiography for a mean of(7.6±5.4) months. The first time followup angiography showed that complete occlusion rate was increased to 92.5%(86 aneurysms). No delayed in-stent stenosis was observed. Three aneurysms recurred, which were completely occluded after receiving coil embolization again. The mean clinical follow-up time for the 96 patients was(18.5±11.2) months, in 95 patients(99.0%) the modified Rankin scale(mRS) score was 0-2 points and they had a good long-term prognosis.Conclusion For the treatment of ophthalmic segment aneurysm

关 键 词：颈内动脉眼动脉段动脉瘤 Neuroform EZ支架 弹簧圈栓塞 

分 类 号：R543.1[医药卫生—心血管疾病]