血流导向装置治疗基底动脉巨大动脉瘤的疗效分析  

Effectiveness and safety of flow diverter for patients with giant basilar artery aneurysm

作　　者：葛慧剑 陈希恒 金恒伟 贺红卫[1] 缪中荣 刘鹏[1] 李佑祥[1] GE Hui-jian;CHEN Xi-heng;JIN Heng-wei;HE Hong-wei;MIAO Zhong-rong;LIU Peng;LI You-xiang(Beijing Neurosurgical Institute,Beijing 100070,China;Department of Interventional Neuroradiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]北京市神经外科研究所/首都医科大学附属北京天坛医院神经介入科,北京100070

出　　处：《中国临床神经外科杂志》2021年第11期823-826,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨血流导向装置(FD)治疗基底动脉巨大动脉瘤的疗效。方法回顾性分析2016年7月至2020年7月采用FD治疗的17例基底动脉巨大动脉瘤的临床资料。结果17例(17个动脉瘤)共置入28枚FD(22枚Pipeline支架,6枚Tubridge支架),成功释放27枚。术后发生并发症共11例(64.7%,11/17),其中缺血6例,出血2例,占位效应加重3例。14例临床随访1~60个月,平均(18.1±16.3)个月;预后良好(改良Rankin量表评分0~2分)11例,重残1例,死亡2例。10例影像学随访3~60个月,平均(17.8±18.9)个月;8例动脉瘤完全闭塞,2例残腔稳定;9例载瘤动脉通畅,1例因术中支架脱入动脉瘤瘤腔内而闭塞基底动脉。结论对于基底动脉巨大动脉瘤,FD治疗的动脉瘤闭塞率较高,效果良好;但是术后并发症不容忽视,临床应注意防治。Objective To explore the effectiveness and safety of flow diverter(FD)for the patients with giant basilar artery aneurysm(GBAA).Methods The clinical data of 17 patients(17 aneurysms)with GBAA who received endovascular treatment using FD from July 2016 to July 2020 were analyzed retrospectively.Results A total of 28 FDs,including 22 Pipeline stents and 6 Tubridge stents,were implanted in these 17 patients and 27 FDs were successfully released.Postoperative complications occurred in 11 patients(64.7%,11/17),including 6 patients of ischemic complications,2 of hemorrhagic complications and 3 of aggravated space-occupying effect.The clinical follow-up of 14 patients(range,1~60 months;average,18.1±16.3 months)showed good prognoses(modified Rankin scale score of 0~2)in 11 patients,severe disability in 1,and death in 2.The radiologic follow-up of 10 patients(range,3~60 months;average,17.8±18.9 months)showed complete occlusion of aneurysms in 8 patients and no change of residual lumen in 2;patency of parient arteries in 9 and occlusion of basilar artery in 1 due to intraoperative stent disengagement from aneurysm.Conclusions For the patients with GBAA,endovacular treatment using FD has high aneurysm occlusion rate and good prognosis.However,clinical prevention and treatment measures should be made to reduce the postoperative complications.

关 键 词：颅内巨大动脉瘤 基底动脉动脉瘤 血流导向装置 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]