Neuroform Atlas支架在宽颈颅内动脉瘤的应用价值  

Application value of Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms

作　　者：杜安东 张学兵 刘带林[1] 蒯涛[1] 白雅林[1] 马东明[1] 许世辉[1] Du Andong;Zhang Xuebing;Liu Dailin;Kuai Tao;Bai Yalin;Ma Dongming;Xu Shihui(Department of Neurosurgery,People's Hospital of Ningxia Hui Autonomous Region,Ningxia Medical University,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院、宁夏医科大学附属自治区人民医院神经外科,宁夏银川750002

出　　处：《中国微侵袭神经外科杂志》2024年第8期449-452,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨颅内宽颈动脉瘤栓塞治疗中Neuroform Atlas支架的临床应用价值。方法回顾性分析52例宽颈动脉瘤患者的临床资料,均在Neuroform Atlas支架的辅助下成功完成介入栓塞手术治疗。采用Raymond Roy分级评估动脉瘤栓塞情况,改良Rankin量表(Modified Rankin Scale,mRS)评分评估患者预后,对术后并发症与动脉瘤复发进行总结结果在52例宽颈动脉瘤患者中,动脉瘤位于大脑中动脉6例,前交通动脉14例,后交通动脉22例,大脑前动脉2例,基底动脉尖2例,椎动脉V4段2例,眼动脉段4例。40例破裂动脉瘤,12例未破裂动脉瘤。术后脑梗死2例,脑梗死合并出血2例,围手术期未见其他明显的介入相关并发症。术后即刻造影显示动脉瘤完全闭塞40例、瘤颈残留6例、瘤体小部分残瘤6例;随访6~12个月,动脉瘤完全闭塞46例,瘤颈残留4例,瘤体小部分残留2例。mRS评分在出院时:0分38例,1分10例,2分2例,3分2例;随访6~12个月,mRS评分0分46例,1分4例,2分2例。结论宽颈动脉瘤患者使用Neuroform Atlas支架辅助弹簧圈栓塞,具有手术成功率高、并发症低等优点,但需进一步跟踪观察其远期效果。Objective To investigate the clinical application value of Neuroform Atlas stent in the embolization treatment of widenecked intracranial aneurysms.Methods The clinical data of 52 patients with wide-necked intracranial aneurysms who underwent interventional embolization with the assistance of Neuroform Atlas stent were analyzed retrospectively.The Raymond-Roy classification was used to assess aneurysm occlusion,and the modified Rankin scale(mRS)was used to evaluate patient outcomes.Postoperative complications and aneurysm recurrence were summarized.Results Among the 52 patients with wide-necked intracranial aneurysms,the aneurysms were located in the middle cerebral artery in 6 cases,anterior communicating artery in 14,posterior communicating artery in 22,anterior cerebral artery in 2,basilar artery apex in 2,vertebral artery V4 segment in 2,and ophthalmic artery segment in 4.Forty patients had ruptured aneurysms,and 12 had unruptured aneurysms.Postoperatively,2 patients developed cerebral infarction,and 2 had cerebral infarction with hemorrhage.No other significant interventional-related complications were observed during the perioperative period.Immediate postoperative angiography revealed complete aneurysm occlusion in 40 cases,neck remnants in 6 cases,and small residual aneurysmal sacs in 6 cases.During the 6-12-month follow-up,complete occlusion was observed in 46 cases,neck remnants in 4 cases,and small residual aneurysmal sacs in 2 cases.At discharge,the mRS scores were 0 in 38 patients,1 in 10,2 in 2,and 3 in 2.After 6-12 months of follow-up,the mRS scores were 0 in 46 patients,1 in 4,and 2 in 2.Conclusions The use of Neuroform Atlas stent-assisted coil embolization in patients with wide-necked intracranial aneurysms offers high surgical success rates and low complication rates.However,further long-term follow-up is needed to observe its long-term outcomes.

关 键 词：颅内动脉瘤 宽颈 弹簧圈栓塞术 Neuroform Atlas支架 

分 类 号：R651.12[医药卫生—外科学]