【摘要】 目的 探讨血流导向装置（FD）治疗急性期破裂血泡样动脉瘤的安全性和有效性。方法回顾性纳入2020-01—2023-05首都医科大学附属北京天坛医院脑血管病科使用FD治疗的10例急性期破裂血泡样动脉瘤患者，根据围手术期并发症和随访结果进行归纳、总结和分析。结果 10例患者的11个动脉瘤共植入11枚FD,6例联合弹簧圈辅助栓塞，所有支架均完全展开且贴壁良好。术后即刻OKM分级B级4个（36.4%）,D级7个（63.6%）。围手术期并发症2例，其中1例术后12 h出现右侧大面积脑梗死，急诊行去骨瓣减压术后治疗无效死亡；1例术后出现肺部感染，经抗感染及其他对症治疗后好转。存活9例患者均通过门诊或电话获得临床随访，mRS评分均为0分。8例通过DSA检查获得影像学随访，中位随访时间（10.3±4.7）个月，OKM分级B级1个（12.5%）,D级7个（87.5%），随访期间未出现缺血性或出血性并发症。结论 应用血流导向装置治疗急性期破裂血泡样动脉瘤安全、可行。更多还原

【Abstract】 Objective To investigate the safety and efficacy of flow diverter(FD)in the treatment of acute ruptured blood blister-like aneurysms.Methods A total of 10 patients with acute ruptured blood blister like aneurysms treated by FD in the Department of Cerebrovascular Diseases,Beijing Tiantan Hospital,Capital Medical University from January 2020 to May 2023 were retrospectively enrolled. The perioperative complications and follow-up results were summarized and analyzed.Results Eleven FDs were implanted in 11 aneurysms of 10 patients,and 6 FDs were coiled-assisted embolization. All FDs were fully deployed and adhered well. OKM grading was grade B in 4 cases(36.4%) and grade D in 7 cases(63.6%) immediately after operation.Perioperative complications occurred in 2 cases,including 1 case of right massive cerebral infarction 12 hours after operation and emergency decompressive craniectomy,which died of ineffective treatment,and 1 case of postoperative pulmonary infection,which improved after anti-infection and other symptomatic treatment. Nine surviving patients were followed up through outpatient clinic or telephone,and m RS score was 0. Eight patients were followed up by DSA,and the median follow-up time was(10.3±4.7)months. According to OKM grade,1(12.5%)was grade B and 7(87.5%)were grade D. No ischemic or hemorrhagic complications occurred during the follow-up period.Conclusion Application of flow diverter in the treatment of acute ruptured blood blister-like aneurysms is safe and feasible.更多还原