国内应用载瘤动脉内血流导向装置治疗颅内动脉瘤最新进展  

Recent advances in the treatment of intracranial aneurysms with flow diversion in parent artery applied in China

作　　者：王诗良 李一星 季金璀 赵秀豪 郭锋[2] 于建军[2] WANG Shiliang;LI Yixing;JI Jincui;ZHAO Xiuhao;GUO Feng;YU Jianjun(Clinical Medical College,Weifang Medical University,Weifang,Shandong 261053,China;Department of Cerebrovascular Surgery,Linyi People's Hospital,Linyi,Shandong 276000,China)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261053 [2]临沂市人民医院脑血管病外科,山东临沂276000

出　　处：《安徽医药》2023年第5期868-875,共8页Anhui Medical and Pharmaceutical Journal

摘　　要：颅内动脉瘤破裂是引起蛛网膜下腔出血的主要原因,其破裂后致死致残率极高;血管内介入治疗因创伤小,恢复快等优势发展迅速并被临床广泛应用,已成为颅内动脉瘤的首选治疗方式。但传统的血管内治疗手段已不能提高复杂动脉瘤的治疗效果,伴随技术和材料进步,血流导向装置出现,使得此类疾病的治疗进入载瘤动脉重建时代。近几年来血流导向装置发展迅速,其疗效得到证实,适应证不断扩展,装置得到完善并更迭换代,新品种逐一上市,围手术期并发症研究也趋于完善,抗血小板聚集药物的归纳研究则为病人提供了安全保障,尽管部分超适应证治疗仍存在争议,但为病人及术者提供了更多的手术方案选择。以下将对国内应用载瘤动脉内血流导向装置治疗颅内动脉瘤最新进展作一综述。Ruptured intracranial aneurysm,associated with high mortality and disability,is the main cause of subarachnoid hemorrhage.The endovascular interventional therapy has been rapidly developed and well recognized as a preferential treatment for intracranial aneurysm,since this therapeutic strategy could remarkably diminish surgical trauma and minimize recovery time.However,the conventional endovascular treatment is incapable of improving the therapeutic outcomes of surgically treated complex intracranial aneurysm.Instead,with advances in techniques and materials,flow diverter(FD) has emerged as a new generation of endoluminal implants that are designed to treat intracranial aneurysm by reconstructing the diseased parent artery.Over the past years,flow divert devices have been securely applied and achieved convincing outcomes in more untreatable cases,accompanied with significant improvement and upgrading.New FDs are launched.There is a better understanding of complications during perioperative period and inductive researches about antiplatelet drugs ensure patient safety during the treatment.Although the off-label use of FDs still remains controversial in particular cases,it provides an alternative surgical strategy for patients with intracranial aneurysm.The latest domestic update of the application of FDs in the parent artery for intracranial aneurysm will be presented below.

关 键 词：颅内动脉瘤 血流导向装置 载瘤动脉重建 并发症 抗血小板聚集药物 综述 

分 类 号：R743[医药卫生—神经病学与精神病学]