血流导向装置Tubridge治疗颅内复杂动脉瘤的疗效和安全性观察  

Flow diverter device Tubridge in intracranial complex aneurysms: an efficacy and safety analysis

作　　者：高歌 朱浩 张扬[1] 晁迎九 陈昱[1] 余舰 顾大群 武银刚 牛朝诗 Gao Ge;Zhu Hao;Zhang Yang;Chao Yingjiu;Chen Yu;Yu Jian;Gu Daqun;Wu Yingang;Niu Chaoshi(Department of Neurosurgery,Brain Function and Brain Diseases Key Laboratory of Anhui Province,First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院神经外科、脑功能与脑疾病安徽省重点实验室,合肥230001

出　　处：《中华神经医学杂志》2021年第8期771-775,共5页Chinese Journal of Neuromedicine

基　　金：中央引导地方科技创新专项(2019b07030001);中国科学技术大学新医学联合基金(WK9110000199)。

摘　　要：目的观察国产血流导向装置Tubridge治疗颅内复杂动脉瘤的短期疗效及并发症,总结Tubridge治疗颅内复杂动脉瘤的适应证及经验。方法选择中国科技大学附属第一医院神经外科自2020年1月至2020年12月应用血流导向装置Tubridge治疗的31例颅内复杂动脉瘤患者进入研究。术后即刻采用Raymond分级评估动脉瘤的栓塞程度。术后6个月采用改良Rankin量表(mRS)评分评估患者预后。术后6个月、12个月患者行DSA复查以明确动脉瘤的栓塞情况。结果31例患者共37个动脉瘤。37个动脉瘤共置入32枚Turbridge,均成功输送并释放,其中13个瘤体填塞弹簧圈(术后即刻DSA检查显示Raymond分级Ⅰ级8个,Raymond分级Ⅱ级2个,Raymond分级Ⅲ级3个),24个瘤体未填弹簧圈。1例患者术后发生缺血性并发症,无出血性并发症发生、无死亡患者。随访时31例患者均预后良好。术后6个月24例(77.4%)患者行DSA复查显示动脉瘤完全闭塞17例(70.8%)。术后12个月25例患者行DSA复查显示动脉瘤完全闭塞19例(76%)。结论应用新型国产血流导向装置Tubridge治疗颅内复杂动脉瘤成功率高、围手术期并发症少,安全性较高,患者预后良好。Objective To observe the short-term efficacy and complications of flow diverter device Tubridge in the treatment of complex intracranial aneurysms,and to summarize the indications and experience of Tubridge in treatment of complex intracranial aneurysms.Methods Thirty-one patients with complex intracranial aneurysms accepted treatment with assistance of Tubridge in our hospital from January 2020 to December 2020 were enrolled.Raymond grading was used to evaluate the degrees of aneurysm embolization immediately after surgery.Modified Rankin scale(mRS)was used to evaluate the prognoses 6 months after surgery.The embolization of aneurysms was determined in these patients by DSA 6 and 12 months after surgery.Results Thirty-seven aneurysms were noted in these 31 patients.A total of 32 diverters(Turbridge)were implanted into these 37 aneurysms,and all of which were successfully delivered and released.Thirteen aneurysms were filled with spring coils(8 with Raymond grading I,2 with Raymond grading II,3 with Raymond grading III by DSA immediately after surgery),and 24 aneurysms were not filled with spring coils.Postoperative ischemic complications occurred in 1 patient,and no hemorrhagic complications or death were noted.All 31 patients had good prognosis at follow-up.Six months after surgery,DSA re-examination in 24 patients(77.4%)showed that complete occlusion of aneurysms was achieved in 17 patients(70.8%).DSA re-examination 12 months after surgery showed complete occlusion of aneurysms in 19 of the 25 patients(76%).Conclusion The new domestic flow diverter device Tubridge has a high success rate,less perioperative complications,high safety,and good recovery in the treatment of complex intracranial aneurysm.

关 键 词：颅内动脉瘤 血管内治疗 Tubridge 血流导向装置 

分 类 号：R651.12[医药卫生—外科学]