Surpass Streamline血流导向装置治疗颅内动脉瘤的初步分析  

Preliminary experience in the treatment of intracranial aneurysms with Surpass Streamline blood flow diverter

作　　者：许斌 刘耀 白卫星 康晓雨 徐田明 顾建军 薛绛宇 李立 李天晓 Xu Bin;Liu Yao;Bai Weixing;Kang Xiaoyu;Xu Tianming;Gu Jianjun;Xue Jiangyu;Li Li;Li Tianxiao(Cerebrovascular Division of Interventional Therapy Center,Henan Provincial People′s Hospital(Zhengzhou University People′s Hospital),Zhengzhou 450003,China)

机构地区：[1]河南省人民医院(郑州大学人民医院)脑血管病介入治疗中心,郑州450003

出　　处：《中华神经外科杂志》2023年第7期669-673,共5页Chinese Journal of Neurosurgery

基　　金：河南省卫生健康委员会医学科技攻关计划(SB201901068)。

摘　　要：目的初步探讨Surpass Streamline血流导向装置(FD)治疗颅内动脉瘤的安全性和有效性。方法回顾性分析2020年12月至2022年3月河南省人民医院脑血管病介入治疗中心采用Surpass Streamline FD治疗的11例颅内动脉瘤患者的临床资料。11例患者共14个动脉瘤,其中位于颈内动脉13个,椎动脉V4段1个。术后即刻及随访时采用全脑数字减影血管造影(DSA)评估动脉瘤的闭塞情况,并采用O′Kelly-Marotta(OKM)分级评估动脉瘤的栓塞程度;采用改良Rankin量表评分(mRS)评价患者的神经功能。结果14个动脉瘤共置入11枚Surpass Streamline FD,全部置入成功。其中6例患者单纯置入Surpass Streamline FD,5例为Surpass Streamline FD+补救性辅助应用支架或球囊扩张。1例辅助应用球囊扩张的患者发生围手术期缺血性并发症,出院时mRS为3分。术后即刻DSA显示OKM分级为A级1个,B级8个,C级5个。11例患者均获得临床随访,中位随访时间[M(Q1,Q3)]为6.0(5.8,7.2)个月,至末次随访,mRS 2分者1例,0分者10例。共6例患者(6个动脉瘤)获得DSA随访,中位随访时间[M(Q1,Q3)]为6.2(5.8,6.4)个月,末次随访显示,OKM分级为D级5个,C级1个;1例患者发生无症状性支架内狭窄。结论初步观察Surpass Streamline FD治疗颅内动脉瘤的技术成功率高,对动脉瘤的即刻疗效满意,并发症发生率较低,短期随访安全、有效。Objective To preliminarily investigate the efficacy and safety of Surpass Streamline flow diverter(FD)in the treatment of intracranial aneurysms.Methods A retrospective study was performed on the clinical data of 11 patients with intracranial aneurysms treated with Surpass Streamline FD in the Cerebrovascular Division of Interventional Therapy Center,Henan Provincial People′s Hospital from December 2020 to March 2022.There was a total of 14 aneurysms in 11 patients,13 of which were located in the internal carotid artery and 1 in the V4 segment of the vertebral artery.The whole-brain digital subtraction angiography(DSA)was used to review aneurysm occlusion immediately after surgery and during follow-up and the O′Kelly-Marotta(OKM)grade was used to assess the degree of embolization of aneurysms;The modified Rankin Scale score(mRS)was used to evaluate the neurological function of patients.Results A total of 11 surpass streamline FDs were successfully placed to treat 14 aneurysms.Of those,6 were treated with surpass stream FD only and FD adherence were induced by supplementary stent or Scepter balloon dilation in 5 cases.Perioperative ischemic complications occurred in 1 patient with balloon dilatation and the mRS was 3 points upon discharge.The OKM grade immediately after surgery was grade A in 1 case,grade B in 8 and grade C in 5.All 11 cases underwent clinical follow-up which lasted for 6.0(5.8,7.2)months[M(Q1,Q3)].At the last follow-up,the mRS was 2 points in 1 patient and 0 in the remaining 10 patients.DSA follow-up was obtained in 6 patients,and the median time of follow-up was 6.2(5.8,6.4)[M(Q1,Q3)]months.The OKM grade D was reported in 5 cases and grade C in 1.One case developed asymptomatic in-stent stenosis.Conclusions Surpass streamline FD shows a high procedural success rate for the treatment of intracranial aneurysms.It is associated with favorable immediate postoperative effect and low complication rate.The short-term follow-up indicates its safety and effectiveness.

关 键 词：颅内动脉瘤 血管内操作 治疗结果 血流导向装置 

分 类 号：R743[医药卫生—神经病学与精神病学]