单纯放置LVIS支架治疗颅内动脉瘤的初步经验  

Preliminary experience of simply placing LVIS stents for the treatment of intracranial aneurysms

作　　者：季金璀 郭锋[2] 赵秀豪 李一星 于建军[2] JI Jincui;GUO Feng;ZHAO Xiuhao;LI Yixing;YU Jianjun(School of Clinical Medicine,Weifang Medical University,Weifang 261053,China;Linyi People’s Hospital,Linyi 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,山东临沂276000

出　　处：《中国实用神经疾病杂志》2024年第5期557-562,共6页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 探讨单纯使用LVIS支架治疗颅内动脉瘤(IA)的有效性和安全性。方法 回顾性收集采取单纯LVIS支架治疗的45例患者临床资料,对IA的特征及影像学随访结果进行分析。结果 45例患者通过单纯放置LVIS支架共治疗48个IA。术后4~24个月接受脑血管造影复查,中位复查时间7个月。Raymond分级Ⅰ级的IA 31个,Ⅱ级4个,Ⅲ级13个,总体治愈率64.58%。单LVIS支架治疗30个IA,治愈率56.67%,双LVIS支架套叠治疗18个IA,治愈率77.78%。所有患者获得出院6个月时的门诊或电话随访,均未发生严重缺血或出血事件。改良Rankin量表评分(mRS)均为0~2分。结论 单纯放置LVIS支架治疗IA安全可行,但治愈率低于其辅助弹簧圈栓塞,不宜作为IA的首选治疗方案。对于术中无法填塞弹簧圈或术前不接受血流导向装置以及开颅夹闭术治疗的患者,双LVIS支架治疗可作为备选方案或术中补救措施。Objective To investigate the efficacy and safety of LVIS stent alone in the treatment of intracranial aneurysms(IAs).Methods The clinical data of 45 patients treated by LVIS stent alone were retrospectively collected.The characteristics of IAs and the imaging follow-up results were analyzed.Results A total of 48 IAs were treated in 45 patients with LVIS stents alone.All the patients received cerebral angiography recheck 4-24 months after operation,the median recheck time was 7 months.Raymond classified 31 IAs as gradeⅠ,4 as gradeⅡ,and 13 as gradeⅢ,the overall cure rate was 64.58%.Thirty IAs were treated with single LVIS stent,the cure rate was 56.67%,and 18 IAs were treated with double LVIS stents,the cure rate was 77.78%.All patients received outpatient or telephone follow-up at 6 months after discharge,and no serious ischemia or bleeding events occurred.The modified Rankin scale(m RS)score was 0-2.Conclusion LVIS stent placement alone is safe and feasible for the treatment of IA,but the cure rate is lower than that of LVIS stent assisted coil embolization,so it should not be the first choice for the treatment of IA.However,for patients who cannot have a coil inserted intraoperatively,or who do not receive flow guide device or craniotomy before surgery,double LVIS stents can be an alternative or intraoperative remedy.

关 键 词：LVIS支架 血管内治疗 颅内动脉瘤 血流动力学 并发症 

分 类 号：R743[医药卫生—神经病学与精神病学]