Neuroform Atlas支架辅助弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤安全性及有效性  

Safety and efficacy of Neuroform Atlas stent-assisted embolization with spring coil in the treatment of acute ruptured wide-neck intracranial aneurysms

作　　者：刘带林[1] 钟海龙 薛晓鹏 马东明[1] 刘爱华[2] LIU Dai-lin;ZHONG Hai-long;XUE Xiao-peng;MA Dong-ming;LIU Ai-hua(Department of Neurosurgery,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Department of Cerebrovascular Diseases,Beijing Tiantan Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]宁夏回族自治区人民医院神经外科,宁夏银川750002 [2]首都医科大学附属北京天坛医院脑血管病科,北京100050

出　　处：《临床军医杂志》2024年第4期338-340,345,共4页Clinical Journal of Medical Officers

基　　金：国家自然科学基金(81771233);北京市自然科学基金(7222050);北京“登峰”人才培养计划(DFL20190501);中国脑卒中高危人群干预适宜技术研究及推广项目(GN-2020R0007)。

摘　　要：目的探讨Neuroform Atlas支架辅助弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤的安全性及有效性。方法选取首都医科大学附属北京天坛医院与宁夏回族自治区人民医院自2022年1月至2023年1月收治的88例急性期颅内破裂宽颈动脉瘤患者为研究对象。所有患者均应用Neuroform Atlas支架辅助弹簧圈栓塞术治疗。记录所有患者的手术结果、围术期并发症发生情况及随访结果。结果88例患者(88个破裂动脉瘤)中,共置入92枚Neuroform Atlas支架。术后即刻数字减影血管造影显示,88个破裂动脉瘤中,69个(78.4%)为Raymond分级Ⅰ级,18个(20.5%)为Raymond分级Ⅱ级,1个(1.1%)为Raymond分级Ⅲ级。10例(11.4%)患者发生围术期并发症,包括缺血性并发症9例,出血性并发症1例。61例患者获得影像学随访,动脉瘤闭塞达到Raymond分级Ⅰ级53例(86.9%),Raymond分级Ⅱ级7例(11.5%),Raymond分级Ⅲ级1例(1.6%)。83例患者获得临床随访,改良Rankin量表评分0~2分患者75例(90.4%),3~5分患者8例(9.6%)。结论Neuroform Atlas支架辅助弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤具有较高的栓塞满意率和安全性,且能获得良好的临床预后。Objective To investigate the safety and effectiveness of Neuroform Atlas stent assisted embolization in the treatment of acute ruptured wide-neck intracranial aneurysms.Methods A total of 88 patients with acute intracranial ruptured wide-neck aneurysms were selected from Beijing Tiantan Hospital Affiliated to Capital Medical University and the People′s Hospital of Ningxia Hui Autonomous Region from January 2022 to January 2023.All patients were treated with Neuroform Atlas stent assisted embolization with spring coil.The operative results,perioperative complications and follow-up results of all patients were recorded.Results In 88 patients(88 ruptured aneurysms),a total of 92 Neuroform Atlas stents were implanted.Of the 88 ruptured aneurysms,69(78.4%)were Raymond grade I,18(20.5%)were Raymond gradeⅡ,and 1(1.1%)was Raymond gradeⅢ.Perioperative complications occurred in 10 patients(11.4%),including 9 ischemic complications and 1 hemorrhagic complications.61 patients received imaging follow-up,and 53 patients(86.9%)achieved Raymond grade I aneurysm occlusion,7 patients(11.5%)achieved Raymond gradeⅡaneurysm occlusion,and 1 patient(1.6%)achieved Raymond gradeⅢaneurysm occlusion.The 83 patients were followed up clinically.75 patients(90.4%)scored 0-2 on the modified Rankin scale,and 8 patients(9.6%)scored 3-5.Conclusion Neuroform Atlas stent-assisted coil embolization in the treatment of acute intracranial ruptured wide-neck aneurysms has a higher satisfaction rate and safety,and can obtain a good clinical prognosis.

关 键 词：急性期颅内破裂 宽颈动脉瘤 支架 弹簧圈栓塞术 

分 类 号：R651.12[医药卫生—外科学]