【摘要】 目的 评估支架辅助弹簧圈栓塞梭形动脉瘤术中及术后24 h内，在标准双抗血小板治疗的基础上，短期应用小剂量替罗非班在降低缺血并发症方面的安全性及有效性。方法 回顾分析我中心2015年1月至2020年12月颅内未破裂梭形动脉瘤接受支架辅助弹簧圈栓塞治疗，并在手术过程中及术后24 h内静脉接受替罗非班（0.1μg/kg/min）预防血小板聚集的患者资料。记录并分析围手术期并发症，动脉瘤栓塞程度及术后3个月随访时的mRS评分。结果 本研究共纳入38例患者，39枚动脉瘤，动脉瘤平均直径（6.4±2.1）mm。其中，26枚动脉瘤接受了单支架辅助弹簧圈栓塞治疗，13枚动脉瘤接受了双支架辅助弹簧圈栓塞治疗。术后即刻78.9%(30/38)的动脉瘤实现完全栓塞；在26例接受脑血管造影复查的患者中，92.3%(24/26)的患者动脉瘤实现完全闭塞。围手术期缺血并发症发生率为7.9%(3/38)；无出血并发症发生。3个月随访的良好预后率为97.4%(37/38)(mRS评分为0～1分)。结论 支架辅助弹簧圈栓塞梭形动脉瘤术中及术后24 h内，静脉加用小剂量替罗非班未增加出血并发症。但是，由于样本量偏少，缺少对比，在降低缺血并发症方面的有效性尚需进一步证实。更多还原

【Abstract】 Objective To investigate the safety and efficacy of additional use of tirofiban during and within 24 h after the procedure in the treatment of intracranial fusiform aneurysms with stent-assisted coiling(SAC). Methods From January 2015 to December 2020, patients with intracranial fusiform aneurysms treated with SAC and intravenous administration of tirofiban 0.1 μg/kg/min were retrospectively collected in this study. The measured end points were rates of ischemic events, intracranial hemorrhage and 3 month modified Rankin Scale(mRS). Results A total of 38 patients with 39 aneurysms were identified.Stent-assisted coiling was successful in all cases with single stent-assisted in 26 aneurysms and double stent-assisted in 13 aneurysms, achieving immediate complete aneurysm occlusion in 78.9%(30/38). At 6-month angiographic follow-up, complete aneurysm occlusion was obtained in 92.3%(24/26). Ischemic complications were observed in 7.9%(3/38) of patients. No intracranial hemorrhage was noted. Good outcomes(mRS 0-1) were observed in 97.4%(37/38) of patients at the 3-month follow up. Conclusions Additional use of tirofiban during and within 24 h after the procedure appears to be a safe treatment for fusiform aneurysms treated with SAC.更多还原