Pipeline Flex治疗颈内动脉颅内段中小型动脉瘤的疗效及安全性分析  

Analysis of the Efficacy and Safety of Pipeline Flex in the Treatment of Small and Medium-Sized Intracranial Aneurysms of the Internal Carotid Artery

作　　者：杨钟会 覃英华 杨明昊 胡利刚 唐建勋 姚小琼 唐景峰 YANG Zhonghui;QIN Yinghua;YANG Minghao(Department of Stroke,The Second Affiliated Hospital of Guilin Medical University,Guilin,Guangxi Zhuang Autonomous Region 541199,P.R.China)

机构地区：[1]桂林医学院第二附属医院脑血管病科,541199 [2]桂林医学院人文与管理学院,541199

出　　处：《临床放射学杂志》2024年第5期704-709,共6页Journal of Clinical Radiology

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(编号:Z20201053);广西自然科学基金项目(编号:2022GXNSFAA103006);桂林市科技计划项目(编号:2016012705-11)。

摘　　要：目的 探讨Pipeline Flex血流导向装置(PED)治疗颈内动脉颅内段中小型动脉瘤的疗效及其安全性。方法 回顾性分析18例接受PED治疗颈内动脉颅内段中小型动脉瘤患者,采用Raymond-Roy分级评估术后即刻、术后6个月动脉瘤闭塞情况,采用改良Rankin量表(mRS)评分判断出院时、术后6个月神经功能预后。结果 18例患者均顺利完成手术,15例无任何并发症。3例出现围手术期并发症,2例为出血性脑卒中,其中1例死亡,1例为缺血性脑卒中。术后VASO-CT显示PED贴壁良好,载瘤动脉通畅,Raymond-Roy分级Ⅰ级2例、Ⅱ级5例、Ⅲ级11例。出院时,mRS评分0分15例,1分1例,2分1例,6分1例,良好预后率(mRS评分0~2分)为94.4%。术后除1例死亡,其余17例均获得随访。术后6个月随访行DSA复查Raymond-Roy分级Ⅰ级14例、Ⅱ级2例、Ⅲ级1例。mRS评分0分15例,1分2例,6分1例,良好预后率为94.4%。结论 PED治疗颈内动脉颅内段中小型动脉瘤手术成功率高,并发症发生率低,安全性尚可。Objective To explore the efficacy and safety of Pipeline Flex flow diverting device(PED) in the treatment of small and medium-sized intracranial aneurysms of the internal carotid artery.Methods A retrospective analysis was conducted on 18 patients with intracranial aneurysms of the internal carotid artery treated with Pipeline Flex.The Raymond Roy grading was used to evaluate the occlusion of the aneurysms immediately and 6 months after surgery,and the mRS score was used to determine the neurological prognosis at discharge and 6 months after surgery.Results All 18 patients successfully completed the surgery,and 15 patients had no complications.Three cases experienced perioperative complications,two cases were hemorrhagic stroke of which one died,and one case was ischemic stroke.Postoperative VASO-CT showed good adhesion of PED to the wall and patency of the parent artery.There were 2 cases of Raymond Roy grade I,5 cases of sgrade Ⅱ,and 11 cases of grade Ⅲ.At discharge,there were 15 cases with a mRS score of 0,1 case with a score of 1,1case with a score of 2,and 1 case with a score of 6.The good prognosis rate(mRS score of 0-2) was 94.4%.After 6months of surgery,DSA reexamination was performed in 14 cases of Raymond Roy grade Ⅰ,2 cases of grade Ⅱ,and 1 case of grade Ⅲ.The mRS score was 0 in 15 cases,1 in 2 cases,6 in 1 case,and the good prognosis rate was 94.4%.Conclusion The surgical success rate for treating small and medium-sized intracranial aneurysms of the internal carotid artery is high,with low complications and acceptable safety.

关 键 词：Pipeline Flex血流导向装置 脑动脉瘤 疗效和安全性 

分 类 号：R651.12[医药卫生—外科学]