LVIS支架辅助栓塞颅内大型动脉瘤的疗效  

Efficacy and safety of stent-assisted coiling of large intracranial aneurysms using the low-profile visualized intraluminal support(LVIS)device

作　　者：李孟凯 张义森[2] 王坤[2] 张莹[2] 李文强[3] 田忠彬 刘健[2] LI Meng-kai;ZHANG Yi-sen;WANG Kun;ZHANG Ying;LI Wen-qiang;TIAN Zhong-bin;LIU Jian(Department of Neurosurgery,Yuncheng Central Hospital,Yuncheng 044000,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Neurosurgery,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Cerebrovascular Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510280,China)

机构地区：[1]运城市中心医院神经外一科,山西044000 [2]首都医科大学附属北京天坛医院神经外科中心,北京100070 [3]郑州大学第一附属医院神经外科,郑州450052 [4]南方医科大学珠江医院脑血管病外科,广州510280

出　　处：《中国临床神经外科杂志》2023年第8期500-503,532,共5页Chinese Journal of Clinical Neurosurgery

基　　金：北京市属医院科研培育计划(PX2022022)。

摘　　要：目的探讨LVIS支架辅助弹簧圈栓塞颅内大型动脉瘤的有效性和安全性。方法回顾性分析2014年10月至2017年5月采用LVIS支架辅助栓塞治疗的24例颅内大型动脉瘤的临床资料。结果24例均为单发动脉瘤,动脉瘤最大径10.1~20.2mm,平均为13.7 mm。24个动脉瘤均使用一枚LVIS支架,所有支架都成功打开并顺利完成动脉瘤填塞;术后即刻造影显示Raymond分级Ⅰ级14例,Ⅱ级9例,Ⅲ级1例。3例围手术期出现并发症,包括1例颈内动脉交通段破裂动脉瘤发生术中破裂,1例左侧颈内动脉眼动脉段动脉瘤术后1 h发生支架内血栓形成,1例右侧颈内动脉眼动脉段动脉瘤栓塞术后出现同侧视力障碍。21例(87.5%)进行3.9~36.8个月的临床随访,平均(10.85±8.6)个月,20例mRS评分0分,1例mRS评分1分。18例(75.0%)获得平均9.94个月血管影像学随访,5例动脉瘤出现复发,11例动脉瘤无明显变化,2例动脉瘤进一步愈合。结论LVIS支架辅助栓塞是治疗颅内大型动脉瘤的安全的、可行的方法。Objective To investigate the efficacy and safety of LVIS stent-assisted coil embolization for patients with large intracranial aneurysms.Methods The clinical data of 24 patients with large intracranial aneurysms treated with LVIS stent assisted embolization from October 2014 to May 2017 were retrospectively analyzed.Results The maximum diameter of aneurysms was 10.1~20.2 mm(mean,13.7 mm).All the 24 patients had single aneurysms and were treated with a LVIS stent,all of which were successfully opened and tamped.Immediate postoperative angiography showed Raymond gradeⅠin 14 patients,grade Ⅱ in 9 patients,and grade Ⅲ in 1 patient.Perioperative complications occurred in 3 patients,including intraoperative rupture in 1 patient with communicating segment aneurysm of the internal carotid artery in 1 patient,intra-stent thrombosis in 1 patient with left internal carotid ophthalmic segment aneurysm,and ipilateral visual impairment in 1 patient with right internal carotid ophthalmic segment aneurysm.Twenty-one patients(87.5%)were followed up for 3.9~36.8 months in clinic,with an average of(10.85±8.6)months;a mRS score of 0 was achieved in 20 patients,and a mRS score of 1 in 1.Eighteen patients(75%)were followed up for an average of 9.94 months by angiographic imaging;5 patients had aneurysm recurrence,11 patients had no significant aneurysm change,and 2 patients had aneurysm further healing.Conclusions LVIS stent assisted embolization is a safe and feasible method for the treatment of large intracranial aneurysms.

关 键 词：颅内大型动脉瘤 LVIS支架 血管内治疗 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]