【摘要】 目的探讨国产Willis覆膜支架系统治疗颅内复杂动脉瘤的安全性及有效性。方法 17例颅内复杂动脉瘤患者接受Willis覆膜支架治疗(Willis覆膜支架组),支架置入3个月后进行临床和血管造影随访;同时选取17例颅内复杂动脉瘤患者接受Enterprise支架治疗作为对照组。回顾性收集和分析初始临床资料和随访结果。结果 Willis覆膜支架治疗组:17例动脉瘤患者中,男2例、女15例;年龄40～66岁,平均年龄(54. 9±8. 2)岁;所有支架都成功置入患者载瘤动脉中,术后12例动脉瘤完全闭塞,4例动脉瘤有轻微内漏,1例动脉瘤有明显内漏;出现手术相关并发症2例,并发症发生率为11. 8%,其中1例患者由于术后出现大面积脑梗死病死(5. 9%); 10例患者得到影像学随访,平均随访时间(6. 0±2. 9)个月(5～14个月),结果显示动脉瘤完全闭塞9例,动脉瘤少量内漏1例,载瘤动脉支架内狭窄4例;临床随访(8. 3±4. 3)个月,完全康复15例,临床症状有所改善1例;未发生动脉瘤破裂、血栓栓塞事件或由于覆膜支架置入致穿孔血管闭合而导致的神经功能缺损。Enterprise支架治疗组:17例动脉瘤患者中,男7例、女10例;年龄27～69岁,平均年龄(52. 12±10. 19)岁;所有支架都成功置入患者载瘤动脉中;出现手术相关并发症1例,并发症发生率为5. 9%; 12例患者得到影像学随访,平均随访时间(13. 67±9. 17)个月(5～36个月),结果显示动脉瘤完全闭塞4例,动脉瘤复发7例,动脉瘤保持稳定1例,载瘤动脉支架内狭窄3例,4例复发的动脉瘤再次行栓塞治疗;临床随访(12. 24±7. 99)个月,完全康复17例;未发生动脉瘤破裂、血栓栓塞事件或由于覆膜支架置入导致穿孔血管闭合导致的神经缺损。结论利用Willis覆膜支架进行血管内重构对特定的复杂颅内动脉瘤是一种安全有效的治疗选择,具有良好的短期临床疗效。更多还原

【Abstract】 Aim To investigate the safety and efficacy of the Willis covered stent system for the treatment of complex intracranial aneurysms. Methods Seventeen cases patients( 2 male and 15 female,mean age 54. 9 ± 8. 2) with intracranial aneurysms were treated with Willis covered stents. Clinical and angiographic follow-up were performed after 3 months. The initial procedural and follow-up outcomes were collected and analyzed retrospectively,at the same time, 17 patients with complicated intracranial aneurysms were selected as the control group( 7 male and 10 female,mean age 52. 12 ± 10. 19). Results Willis covered stent treatment group: covered stent placement was successful in 17 patients. A complete aneurysm exclusion was initially achieved in 12 aneurysms,and a minor endoleak occurred in 4 aneurysms,a major endoleak occurred in 1 aneurysm. There are 2 complications related to the procedure in this study( 11. 7%),one of the patients died of cerebral infarction after operation( 5. 8%). The angiographic follow-up( 6. 0 ± 2. 9) months in 10 patients exhibited complete occlusion in 9 aneurysms,and incomplete occlusion in 1 aneurysm. The clinical follow-up( 8. 3 ± 4. 3) months demonstrated that 15 patients experienced a full recovery,and 1 patient improved. No aneurysm rupture,thromboembolic events,or neurological deficits resulting from closure of a perforating vessel by covered stent placement occurred.Enterprise stent treatment group: stent placement was successful in 17 cases patients. A complete aneurysm exclusion was initially achieved in 17 aneurysms. There was 1 complication in this study( 5. 9%). The angiographic follow-up( 13. 67 ± 9. 17) months in 12 patients exhibited complete occlusion in 4 aneurysms,and incomplete occlusion in 7 aneurysm,1 case of aneurysm remains stable. 4 of them were treated with embolization again. The clinical follow-up( 12. 24 ± 7. 99) months demonstrated that 17 patients experienced a full recovery. No aneurysm rupture,thromboembolic events,or neurological deficits resulting from closure of a perforating vessel by covered stent placement occurred. Conclusion Endovascular reconstruction with Willis covered stent represents a safe and curative treatment option for selected intracranial aneurysms,yielding an excellent short-term patency of the parent artery and excellent clinical outcomes.更多还原