Atlas支架“类冰淇淋”技术在伴瘤颈发出重要分支血管的颅内动脉瘤栓塞中的应用  

Feasibility and efficacy of Atlas stents using the waffle-cone technique forintracranial aneurysms with significant branch vessels arising from the aneurysm neck

作　　者：杨松 宋海涛 陈森 纪德峰 徐增良 聂文 YANG Song;SONG Hai-tao;CHEN Sen;JI De-feng;XU Zeng-liang;NIE Wen(Department of Neurosurgery,Jiaozhou Branch,East Hospital Affiliated to Tongji University,Qingdao 266300,China)

机构地区：[1]同济大学附属东方医院胶州医院神经外科,山东胶州266300

出　　处：《中国临床神经外科杂志》2024年第5期274-276,279,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨Atlas支架“类冰淇淋”技术在伴瘤颈发出重要分支血管的颅内动脉瘤栓塞中应用的可行性和有效性。方法回顾性分析2022年1月至2022年9月采用Atlas支架辅助栓塞治疗的10例伴瘤颈发出重要分支血管的颅内动脉瘤的临床资料。结果10例DSA发现动脉瘤颈处发出重要分支血管,术中采用“类冰淇淋”技术辅助栓塞。术后造影显示支架在位良好,动脉瘤致密栓塞,载瘤动脉血流通畅,分支血管血流通畅,未发生出血或缺血性事件。8例术后6个月DSA复查未见动脉瘤复发,载瘤动脉通畅;2例失访。结论针对伴瘤颈发出重要分支血管的颅内动脉瘤,利用Atlas支架远端开环、精准释放、锚定特性的特性,使支架远端部分置于动脉瘤瘤颈,形成“类冰淇淋”技术,保护重要分支血管,支撑弹簧圈,可增加瘤腔内弹簧圈致密度并保护分支血管。Objective To explore the feasibility and efficacy of the waffle-cone technique with Atlas stent in the embolization of intracranial aneurysms with significant branch vessels arising from the aneurysm neck.Methods The clinical data of 10 patients with intracranial aneurysms with significant branch vessels arising from the aneurysm neck treated with Atlas stent-assisted embolization from January 2022 to SeptembeR2022 were retrospectively analyzed.Results DSA revealed significant branch vessels arising from the aneurysm neck in all patients,and the waffle-cone technique was adopted foRassisted embolization during the operation.Postoperative angiography showed that all the stents were in good position,all the aneurysms were densely embolized,the blood flows of the parent arteries and the branch vessels were patent,and no hemorrhagic oRischemic events occurred.Eight patients were followed-up by DSA at 6 months afteRthe operation,and no aneurysm recurrence was found and the parent arteries were patent.Two patients were lost to followup.Conclusions FoRintracranial aneurysms with significant branch vessels arising from the aneurysm neck,by taking advantage of the characteristics of the distal open loop,precise release,and anchoring of the Atlas stent,the distal part of the stent can be placed at the aneurysm neck to form the waffle-cone technique,protecting the significant branch vessels and supporting the coils,which can increase the density of the coils in the aneurysm sac and protect the branch vessels.

关 键 词：颅内动脉瘤 Atlas支架 “类冰淇淋”技术 疗效 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]