Neuroform Atlas单支架辅助弹簧圈栓塞基底动脉尖宽颈动脉瘤(附21例分析)  

Embolization of Basilar Artery Tip Wide-Necked Aneurysm with Neuroform Atlas Single Stent and Coils(Analysis of 21 Cases)

作　　者：丁立山 陈清亮 李腾飞[3] 申猛 梁昊 郑鸣 李照军 马骥[3] DING Lishan;CHEN Qingliang;LI Tengfei(Department of Radiology,The First Affiliated Hospital of Henan Unviersity of Chinese Medicine,Zhengzhou,Henan Province 450099,P.R.China)

机构地区：[1]河南中医药大学第一附属医院,郑州450099 [2]河南省直第三人民医院放射科,郑州450006 [3]郑州大学第一附属医院放射介入科,450052

出　　处：《临床放射学杂志》2024年第9期1576-1580,共5页Journal of Clinical Radiology

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20210255);河南省中青年卫生健康科技创新杰出青年人才培养项目(编号:YXKC2022029)。

摘　　要：目的探讨Neuroform Atlas单支架在基底动脉尖宽颈动脉瘤辅助栓塞中的临床应用价值。方法回顾性分析2022年1月至2023年6月收治并采用Neuroform Atlas单支架辅助弹簧圈栓塞基底动脉尖宽颈动脉瘤患者的临床和影像学资料。采用Raymond-Roy分级表对动脉瘤术后即刻闭塞情况进行评估并观察围手术期并发症发生情况。使用Hunt-Hess分级和改良Rankin量表(mRS)对治疗前后及后续随访中患者的神经精神状况进行评估,并依据术后3~6个月DSA随访结果评价动脉瘤的短期闭塞效果。观察并记录随访期间新发缺血性卒中或动脉瘤破裂出血等不良事件的发生情况。结果共有21例患者纳入研究,其中15例为破裂动脉瘤(术前Hunt-Hess分级Ⅰ级10例,Ⅱ级3例,Ⅲ级1例和Ⅳ级1例),6例为未破裂动脉瘤。所有患者均在单一Neuroform Atlas支架辅助下完成栓塞,技术成功率100%。术后即刻造影显示动脉瘤完全栓塞(Raymond-RoyⅠ级)20例和瘤颈残留(Ⅱ级)1例。术中及围手术期未观察到介入操作相关的并发症发生,出院前mRS评分0~1分16例,2分3例和3分2例。所有患者术后均获得临床随访(随访时间3~14个月),末次随访时所有患者均无新发神经系统症状,mRS评分0~1分19例,2分1例,3分1例;12例术后3~6个月行DSA,动脉瘤均完全闭塞(Raymond-Roy分级Ⅰ级)同时未见载瘤动脉狭窄或支架内闭塞。结论Neuroform Atlas单支架辅助弹簧圈栓塞治疗基底动脉尖宽颈动脉瘤疗效确切,安全性高,具有较高的临床应用价值。Objective To explore the clinical application value of Neuroform Atlas single stent in assisted embolization of basilar artery apex wide-necked aneurysms.Methods The clinical and imaging data of patients with basilar artery apex wide-necked aneurysms who were admitted to two hospitals from January 2022 to June 2023 and underwent Neuroform Atlas single stent-assisted coil embolization were retrospectively analyzed.The Raymond-Roy grading scale was used to evaluate the immediate occlusion of the aneurysm after surgery,and the incidence of perioperative complications was observed.The Hunt-Hess grading and modified Rankin scale(mRS)were used to evaluate the neuropsychiatric status of the patients before and after treatment and during follow-up,and the short-term occlusion effect of the aneurysm was evaluated based on the DSA follow-up results 3 to 6 months after surgery.The occurrence of adverse events such as new ischemic stroke or aneurysm rupture and bleeding during the follow-up period was observed and recorded.Results A total of 21 patients were included in this study,of which 15 had ruptured aneurysms(preoperative Hunt-Hess gradeⅠin 10 cases,gradeⅡin 3 cases,gradeⅢin 1 case,and gradeⅣin 1 case),and 6 had unruptured aneurysms.All patients underwent embolization with the assistance of a single Neuroform Atlas stent,with a technical success rate of 100%.Immediate postoperative angiography showed complete embolization of the aneurysm(Raymond-Roy gradeⅠ)in 20 cases and residual aneurysm neck(gradeⅡ)in 1 case.No complications related to the interventional procedure were observed during and around the operation.Before discharge,the mRS scores were 0-1 in 16 cases,2 in 3 cases,and 3 in 2 cases.All patients were followed up clinically after surgery(follow-up time 3-14 months).At the last follow-up,all patients had no new neurological symptoms.The mRS score was 0-1 in 19 cases,2 in 1 case,and 3 in 1 case.DSA angiography was performed in 12 cases 3-6 months after surgery,and the aneurysms were completely occlu

关 键 词：动脉瘤 基底动脉尖 Neuroform Atlas支架 栓塞 

分 类 号：R651.12[医药卫生—外科学]