双微导管与支架辅助技术治疗颅内未破裂宽颈分叶状动脉瘤的疗效对比分析  

Comparative analysis of the efficacy of double microcatheter and stent-assisted technology in the treatment of intracranial unruptured wide-necked lobulated aneurysms

作　　者：崔斯童 马骏 刘亮 夏加庚 刘振 Cui Sitong;Ma Jun;Liu Liang;Xia Jiageng;Liu Zhen(Department of Neurosurgery,Nanjing First Hospital,Jiangsu Nanjing 210006;Department of Neurosurgery,Brain Hospital of Nanjing Medical University,Jiangsu Nanjing 210006,China)

机构地区：[1]南京市第一医院神经外科,江苏南京210006 [2]南京医科大学附属脑科医院神经外科,江苏南京210006

出　　处：《中华介入放射学电子杂志》2024年第3期200-205,共6页Chinese Journal of Interventional Radiology：electronic edition

基　　金：国家自然科学基金(82203637);江苏省中医药科技项目(YB2020036)。

摘　　要：目的对比分析双微导管栓塞与支架辅助栓塞技术治疗颅内未破裂宽颈分叶状动脉瘤的临床效果。方法回顾性纳入2012年1月至2022年12月南京市第一医院神经外科治疗的95例未破裂宽颈分叶状动脉瘤患者,其中双微导管治疗34例,支架辅助61例,根据治疗前后各指标情况综合评估两方法的疗效。结果双微导管组和支架辅助组截至术后1年各复发6例和2例,差异有统计学意义(P<0.05);术后Raymond分级Ⅰ~Ⅱ级各28和47例,差异有统计学意义(P<0.05);血栓事件各1例和3例,mRS评分≤2分各32例和57例,GOS评分5分各33例和58例,术中动脉瘤破裂各1例和2例,差异无统计学意义(P>0.1)。结论双微导管和支架辅助技术均可有效治疗颅内未破裂宽颈分叶状动脉瘤。支架辅助疗法栓塞致密度更高,双微导管技术复发率较高。Objective To compare the clinical effect of double microcatheter and stent-assisted techniques in the intravascular interventional treatment of unruptured intracranial wide neck lobulated aneurysm.Methods Ninety-five patients with unruptured wide-neck lobular aneurysms treated by neurosurgery department of Nanjing First Hospital from January 2012 to December 2022 were retrospectively included,including 34 patients treated with double microcatheter and 61 patients treated with stent-assisted technique.The therapeutic effects of the two methods were compared and analyzed from the indicators before and after the treatment.Results Among the patients treated with dual microcatheter technique and the patients treated with stent-assisted technology,up to one year after the operation,there were 6 cases and 2 cases of recurrence.There was statistically significant differences in the recurrence rate between the two groups of patients(P<0.05).There were 28 and 47 cases of RaymondⅠ-Ⅱgrade,respectively.There was a statistically significant difference in the degree of embolization between the two groups of patients(P<0.1).There were 4 cases of thrombotic events,including 1 case with dual microcatheter technique and 3 cases with stent-assisted technique.There were 32 and 57 patients with mRS≤2,and 33 and 58 patients with GOS score of 5 in dual microcatheter and stent-assisted therapy,respectively.There were 1 and 2 cases of intraoperative aneurysm rupture in dual microcatheter and stent-assisted therapy,respectively.There were no statistically significant differences in the incidence of aneurysm rupture events,mRS and GOS scores after the operation(P>0.1).Conclusion Double microcatheter and stent-assisted techniques can effectively treat unruptured wide-necked lobular aneurysms.Stent-assisted embolization has a higher embolic density,but a higher risk of bleeding.Double-microcatheter embolization is more economically safe and has a lower risk of bleeding but a higher recurrence rate.

关 键 词：双微导管技术 支架辅助技术 未破裂颅内宽颈分叶状动脉瘤 疗效分析 

分 类 号：R73[医药卫生—肿瘤]