【摘要】 目的探讨支架辅助弹簧圈治疗颅内动脉瘤的疗效、安全性及并发症防治。方法回顾性分析采用颅内支架治疗的27例颅内复杂动脉瘤患者,其中颈内动脉海绵窦段13例,颈内动脉床突上段9例,椎基底动脉系5例(椎动脉2个,小脑上动脉1个,基底动脉顶端2个)。18例先行支架瘤颈成形,将微导管通过支架网眼置入动脉瘤内,填塞弹簧圈。9例先置入微导管于动脉瘤内,再释放支架后栓塞。结果共28枚支架均成功释放,动脉瘤腔完全栓塞19例,填塞90%以上4例,填塞80%以下3例;术中动脉瘤破裂1例;术后脑梗塞2例,1个月后恢复;偏瘫1例;死亡1例。术后平均随访时间3～12个月,均无再出血及血栓栓塞症状发生,动脉瘤复发1例。结论采用支架辅助弹簧圈治疗颅内复杂动脉瘤是行之有效的方法,拓宽了血管内治疗对动脉瘤的解剖要求。更多还原

【Abstract】 Objective To evaluate the efficacy,safety and complications of stent-assisted coil placement in the treatment of complex intracranial aneurysms.Methods The clinical data of 27 patients with complex intracranial aneurysms treated with combined stent and coils were analyzed retrospectively,including 13 cavernous portion of the internal carotid artery(ICA) aneurysms,9 supraclinoid internal carotid artery aneurysms,2 vertebral aneurysm,1 anterior inferior cerebellar artery aneurysm,2 basilar artery aneurysms.The stents were firstly released in 18 cases,then microcatheter were inserted into aneurysms through the lumina of stents and coils were implanted;the microcatheter were firstly inserted into aneurysm in 9 cases,then Neuroform stents were released for embolization.Results Total 28 stents were successfully deployed.Complete embolization was achieved in 19 patients,filling over 90% in 4 cases and less than 80% in 3 cases.Rupture occurred in 1 aneurysm during coiling;2 patients were with cerebral infarction and were completely recovered 1 month later;1 patient was with hemiplegia.1 patient died.27 patients were followed up for 3 to 12 months and there was no re-bleeding and thrombus.The intracranial aneurysm reoccurred in one case.Conclusion The endovascular stents implantation combined with the coil placement is an effective method in the treatment of intracranial aneurysms,which can broaden the extent of indications.更多还原