激光雕刻/编织支架辅助弹簧圈栓塞绝对宽颈破裂动脉瘤的疗效对比  

Efficacy of laser-engraved stent versus braided stent in assisting coil embolization of ruptured absolutely wide-necked aneurysms

作　　者：邱文串 韩杨 万学焱[2] 朱明欣[2] 杨海 曾亮[2] QIU Wen-Chuan;HAN Yang;WAN Xue-Yan;ZHU Ming-Xin;YANG-Hai;ZENG Liang(Department of Neurosurgery,Tianyou Hospital,Wuhan University of Science and Technology,Wuhan,Hubei 430064,China;Department of Neurosurgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430060,China;Department of Neurosurgery,Taikang Tongji(Wuhan)Hospital,Wuhan,Hubei 430050,China)

机构地区：[1]武汉科技大学附属天佑医院神经外科,湖北武汉430064 [2]华中科技大学同济医学院附属同济医院神经外科,湖北武汉430060 [3]泰康同济(武汉)医院神经外科,湖北武汉430050

出　　处：《国际神经病学神经外科学杂志》2022年第4期38-41,共4页Journal of International Neurology and Neurosurgery

摘　　要：目的比较研究编织支架和激光雕刻支架辅助栓塞颅内破裂动脉瘤的疗效及优缺点。方法回顾性分析60例颅内破裂宽颈动脉瘤的临床资料,根据支架的制造工艺分为编织支架组(n=30)与激光雕刻支架组(n=30)。统计分析两组患者术前一般资料、围术期并发症、术后即刻Raymond分级、术后随访Raymond分级及预后情况。结果编织支架组的预后良好率90.0%高于激光雕刻支架组的73.3%,差异有统计学意义(P<0.05),编织支架组和激光雕刻支架组远期闭塞率Ⅰ级分别为90%、63.3%,Ⅱ级分别为6.7%、10.0%,和Ⅲ级分别为3.3%、26.7%,两组间差异有统计学意义(P<0.05)。两组患者年龄,性别比,术前Hunt-Hess改良分级,动脉瘤位置(编织支架组大脑前动脉4例、大脑中动脉10例、颈内动脉11例、椎基底动脉5例;激光雕刻支架组大脑前动脉5例、大脑中动脉8例、颈内动脉13例、椎基底动脉4例),术后即刻Raymond分级及术中血栓形成,术后脑梗死,术中动脉瘤再破裂比较,差异无统计学意义(P>0.05)。结论编织支架和激光雕刻支架辅助栓塞颅内破裂宽颈动脉瘤均是安全有效的,编织支架远期的栓塞程度更好及预后更佳,且围术期并发症无明显差异。Objective To investigate the efficacy,advantages,and disadvantages of braided stent versus laser-engraved stent in assisting embolization of ruptured intracranial aneurysms.Methods A retrospective analysis was performed for the clinical data of 60 patients with ruptured wide-necked intracranial aneurysms,and according to the stent manufacturing process,they were divided into braided stent group with 30 patients and laser-engraved stent group with 30 patients.A statistical analysis was performed for general data before surgery,perioperative complications,Raymond grade immediately after surgery and during postoperative follow-up,and prognosis.Results The braided stent group had a significantly higher good prognosis rate than the laser-engraved stent group(90.0%vs 73.3%,P<0.05).There were significant differences between the braided stent group and the laser-engraved stent group in the rates of Raymond gradeⅠocclusion(90%vs 63.3%,P<0.05),Raymond gradeⅡocclusion(6.7%vs 10.0%,P<0.05),and Raymond gradeⅢocclusion(3.3%vs 26.7%,P<0.05).There were no significant differences between the two groups in age,sex ratio,modified Hunt-Hess grade before surgery,location of aneurysm(in the braided stent group,4 patients had aneurysm in the anterior cerebral artery,10 had aneurysm in the middle cerebral artery,11 had aneurysm in the internal carotid artery,and 5 had aneurysm in the vertebral basilar artery;in the laser-engraved stent group,5 patients had aneurysm in the anterior cerebral artery,8 had aneurysm in the middle cerebral artery,13 had aneurysm in the internal carotid artery,and 4 had aneurysm in the vertebral basilar artery),Raymond grade immediately after surgery,intraoperative thrombosis,postoperative cerebral infarction,and intraoperative aneurysm re-rupture(P>0.05).Conclusions Both braided stent and laser-engraved stent are safe and effective in stent-assisted embolization of ruptured wide-necked intracranial aneurysms.Braided stent tends to have better long-term embolization and prognosis,and there is no signific

关 键 词：颅内宽颈动脉瘤 栓塞 支架 弹簧圈 疗效 

分 类 号：R651.12[医药卫生—外科学]