天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (8): 868-871.doi: 10.11958/20170470

• 临床研究 • 上一篇    下一篇

超早期支架辅助弹簧圈治疗颅内破裂宽颈 动脉瘤的疗效观察

高培龙， 胡群亮， 李建伟， 田竺， 苏娅， 郝占坡   

  1. 武警后勤学院附属医院神经外科 （邮编 300162）
  • 收稿日期:2017-04-14 修回日期:2017-06-12 出版日期:2017-08-15 发布日期:2017-08-15
  • 作者简介:高培龙 （1970）， 男， 副主任医师， 主要从事脑血管病介入、 卒中相关研究

The effect of ultra-early stent-assisted coil embolization in the treatment of ruptured widenecked intracranial aneurysms

GAO Pei-long, HU Qun-liang, LI Jian-wei, TIAN Zhu, SU Ya, HAO Zhan-po   

  1. Department of Neurosurgery, Logistics University of Chinese People’ s Police Forces, Tianjin 300162, China
  • Received:2017-04-14 Revised:2017-06-12 Published:2017-08-15 Online:2017-08-15

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摘要： 目的 探讨超早期支架辅助弹簧圈治疗颅内破裂宽颈动脉瘤的效果。方法 回顾性分析在超早期支架辅 助弹簧圈治疗的 24 例颅内破裂宽颈动脉瘤患者的血管造影情况和临床资料， 男 8 例， 女 16 例， 年龄 29~86 岁， 中位 数 59 岁， 观察术后并发症及临床疗效。根据 Raymond 分级标准评估术后栓塞情况， 依据改良 Rankin 量表 （mRS） 评 分评估术后 6~12 个月随访结果。结果 3 例患者出现手术相关并发症（12.5%）， 均为出血性事件， 其中 2 例死亡。 围手术期死亡 3 例。存活的 19 例患者中 17 例恢复良好 （mRS 0~2）。术后 6~12 个月数字减影血管造影 （DSA） 随访 10 例患者， 未发现动脉瘤复发。结论 超早期支架辅助弹簧圈治疗颅内破裂宽颈动脉瘤， 可提高栓塞成功率， 减少复发。

关键词: 颅内动脉瘤, 支架, 颅内破裂宽颈动脉瘤, 支架辅助弹簧圈, 超早期

Abstract: Objective To explore the efficacy of ultra - early stent - assisted coil (SAC) in the treatment of intracranial rupture of wide - necked aneurysms. Methods The angiographic and clinical data of 24 patients (including 8 male, 16 female, age ranged from 29 to 86 years, with a median age 59) with acutely ruptured wide-necked intracranial aneurysms treated with SAC were retrospectively analyzed. The postoperative complications and clinical results were observed. The postoperative embolization was assessed according to the Raymond grading standard. The assessment of the follow-up results from 6 to 12 months after procedure was observed according to the modified Rankin Scale (mRS) score. Results Procedurerelated complications occurred in 3 patients (12.5% ). All of them were hemorrhagic events, of which 2 cases died. Perioperative death was found in 3 cases. Of the 19 surviving patients, 17 showed good recovery (mRS 0-2). After 6 to 12 months of DSA, no recurrence of aneurysm was found in 10 follow-up patients. Conclusion Ultra-early stent-assisted coil treatment for intracranial wide- neck rupture aneurysm can improve the success rate of embolization and reduce the recurrence.

Key words: intracranial aneurysm, stents, ruptured wide-necked intracranial aneurysms, stent-assisted coiling, ultraearly stage