联合自膨胀颅内支架和生物活性弹簧圈栓塞1例海绵窦宽颈动脉瘤  

Combined Neuroform intracranial stent and bioactive Matrix detachable coil for embolization a wide-necked cavernous intracranial aneurysm: technique case report

作　　者：胡锦清[1] 林东[1] 沈建康[1] 赵卫国[1] 

机构地区：[1]上海第二医科大学附属瑞金医院神经外科,上海200025

出　　处：《中国微侵袭神经外科杂志》2004年第1期5-8,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的报道采用自膨胀专用颅内支架Neuroform和生物活性弹簧圈Matrix栓塞1例宽颈海绵窦动脉瘤的经验。方法对一女性48岁多发性脑动脉瘤病人,在栓塞其破裂的前交通动脉瘤后5个月,采用国际上第1个专用颅内支架Neuroform和第1种具有生物活性的弹簧圈Matrix栓塞另一伴发的宽颈海绵窦动脉瘤。结果支架成功置入载瘤动脉的瘤颈处,并经插入支架网眼内的微导管在动脉瘤内填入3个Matrix电解脱弹簧圈,动脉瘤闭塞95%以上,载瘤动脉通畅。病人无神经功能症状,弥散加权MR未见脑缺血灶,MRA和TCD未见脑血管痉挛,术后5d出院。结论Neuroform颅内支架使用方便、安全,适用于颅内宽颈动脉瘤的支架辅助弹簧圈栓塞,特别适用于迂曲的脑血管。Objective To report our preliminary clinical experience with combination of Neuroform self-expanding intracranial stent and bioactive Matrix detachable coil for embolization a wide-necked internal carotid artery-cavernous aneurysm. Methods A 48-year-old female presented with subarachnoid hemorrhage was admitted to our department. The cerebral angiogram revealed a ruptured anterior communicating artery aneurysm (AComAA) and an unruptured wide-necked cavernous aneurysm. The patient received embolization of ACoAA with electrolytically detachable coils. Five months later, the cavernous aneurysm was treated by combination of Neuroform self-expanding intracranial stent and bioactive Matrix detachable coil. Results The Neuroform self-expanding intracranial stent was successfully covered aneurysm neck and the aneurysm dome was packed with 3 Matrix detachable coils through the stent interstices. The aneurysm was 95% occlusion angiogarphically and the parent artery was patency. The patient was neurological intact after embolization. The post-embolization diffusion MR did not reveal any ischemic lesion. MRA and TCD also did not show any distinct cerebral vasospasm. The patient was discharged after 5 days and waiting for 3 months follow-up angiography. Conclusion The Neuroform stent is a very easy and safe intracranial stent for embolization of wide-necked intracranial aneurysm. It is very suitable for wide-necked intracranial aneurysm with severely tortuous parent artery. Although a good angiographic result is achieved, long-term angiographic follow-up is necessary.

关 键 词：颅内动脉瘤 宽颈动脉瘤 电解脱弹簧圈 血管内治疗 自膨胀支架 

分 类 号：R651.1[医药卫生—外科学]