Pipeline栓塞装置辅助弹簧圈栓塞治疗颈内动脉破裂血泡样动脉瘤的疗效分析  

Clinical efficacy of Pipeline embolization divice assisted coil embolization for patients with ruptured blood blister-like aneurysms of the internal carotid artery

作　　者：郭凯 王增武[1] 王鹏成 王媛媛 GUO Kai;WANG Zeng-wu;WANG Peng-cheng;WANG Yuan-yuan(Department of Neurosurgery,Weifang People's Hospital,Weifang 261000,China)

机构地区：[1]潍坊市人民医院神经外科,山东216000

出　　处：《中国临床神经外科杂志》2023年第7期433-436,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的 探讨Pipeline栓塞装置(PED)辅助弹簧圈栓塞治疗颈内动脉破裂血泡样动脉瘤的疗效。方法 回顾性分析2018年10月至2021年4月应用PED辅助弹簧圈栓塞治疗的20例颈内动脉破裂血泡样动脉瘤的临床资料。结果 20例共用22枚支架,均成功置入载瘤动脉。术后即刻DSA显示Raymond分级Ⅰ级18例,Ⅱ级2例。术后24 h内发生缺血并发症4例,术后1 d突发术区出血后死亡1例。19例存活病人出院后随访8~46个月,平均(22.7±7.3)个月;术后6个月DSA显示动脉瘤完全不显影,载瘤动脉通畅;术后6个月mRS评分0分12例,1分6例,2分1例。结论 PED辅助弹簧圈栓塞治疗颈内动脉破裂血泡样动脉瘤的临床预后良好,安全有效,短期内再出血率低,但仍需更长时间的随访和较大样本的随机对照研究证实。Objective To investigate the clinical efficacy of Pipeline embolization device(PED)assisted coil embolization for patients with ruptured blood blister-like aneurysms(BBA)of the internal carotid artery(ICA).Methods The clinical data of 20 patients with BBA of the ICA treated with PED assisted coil embolization from October 2018 to April 2021 were retrospectively analyzed.Results Twenty-two stents were used in the 20 patients,and all the stents were successfully implanted into the parent arteries.Immediate postoperative DSA showed Raymond gradeⅠin 18 patients and gradeⅡin 2.Ischemic complications occurred in 4 patients within 24 h after the surgery,and 1 patient died of sudden bleeding in the operative area 1 day after the surgery.Of 19 surviving patients who were followed up for 8 to 46 months after discharge(average,22.7±7.3 months),DSA showed complete occlusion of aneurysms and patency of parent arteries in these patients 6 months after the operation;a mRS score of 0 was achieved in 12 patients,a mRS score of 1 in 6,and a mRS score of 2 in 1.Conclusions PED assisted coil embolization is a safe and effective method in the treatment of patients with BBA of the ICA,with low short-term rebleeding rate.But it still needs longer follow-up and randomized controlled studies with larger samples to confirm.

关 键 词：颈内动脉血泡样动脉瘤 颅内破裂动脉瘤 血管内治疗 Pipeline栓塞装置 弹簧圈 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]