【摘要】 目的 初步分析Neuroform Atlas支架辅助栓塞治疗急性期颅内破裂宽颈动脉瘤的临床疗效和安全性。方法 回顾性纳入2021-01—2023-03在北京天坛医院和宁夏回族自治区人民医院两家中心神经外科接受Neuroform Atlas支架治疗的182例急性期破裂颅内宽颈动脉瘤患者的临床资料，分析治疗效果、围手术期并发症、出院时神经功能恢复状态及随访结果。结果 182例患者中植入的Neuroform Atlas支架均成功部署，技术成功率100%。术后DSA检查显示，182个破裂动脉瘤中，Raymond-Ray分级Ⅰ级148个，Ⅱ级28个，Ⅲ级6个。19例患者发生围手术期手术相关并发症，其中缺血性15例，出血性4例。出院时预后良好157例，预后不良25例。123例获得术后影像学随访，动脉瘤闭塞分级达Raymond-RayⅠ级107个，Ⅱ级12个，Ⅲ级4个，未发现支架内重度狭窄或闭塞，未发现随访期内动脉瘤再破裂出血或缺血性事件。175例患者接受临床随访，预后良好162例，预后不良13例。结论 急性期颅内破裂宽颈动脉瘤采用Neuroform Atlas支架辅助栓塞安全、有效，但仍需大样本研究及长期观察随访进一步验证。更多还原

【Abstract】 Objective To investigate the safety and effectiveness of Neuroform Atlas stent-assisted embolization for acutely ruptured intracranial aneurysms.MethodsA retrospective analysis was conducted on the clinical data of 182 patients with acutely ruptured wide-necked intracranial aneurysms who treated by Neuroform Atlas in the Department of Neurosurgery,Beijing Tiantan Hospital and People’s Hospital of Ningxia Hui Autonomous Region from January 2021 to March 2023. The treatment effect,perioperative complications,neurological function recovery status at discharge and follow-up were analyzed.ResultsNeuroform Atlas stents were successfully released in all 182 patients,and the stent deployment was satisfactory. DSA examination immediately after the operation showed that among the 182 ruptured aneurysms,there were 148 cases of Raymond-Ray grade Ⅰ,28 cases of grade Ⅱ,and 6 cases of grade Ⅲ. Perioperative procedure-related complications occurred in 19 patients, including ischemic complications in 15 patients and hemorrhagic complications in 4 patients. At discharge,favorable prognosis were achieved in 157 patients and 25 patients had poor prognosis. The imaging follow-up results of 123 patients showed that the aneurysm occlusion reached Raymond-Ray grade Ⅰ in 107 cases,grade Ⅱ in 12 cases,and grade Ⅲ in 4 cases. No severe stenosis or occlusion in the stent was found,and no aneurysm re-rupture was found during the follow-up period. A total of175 patients received clinical follow-up,favorable prognosis were achieved in 162 patients and 13 patients had poor prognosis.ConclusionNeuroform Atlas stent-assisted embolization of acutely ruptured intracranial aneurysms is safe and effective. However,large sample studies and long-term follow-up are needed for further verification.更多还原