Solitaire AB支架辅助弹簧圈栓塞颅内宽颈动脉瘤的临床研究.docVIP

Solitaire AB支架辅助弹簧圈栓塞颅内宽颈动脉瘤的临床研究 　　[摘要] 目的 探讨神经血管重塑装置（solitaire AB）支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的临床效果。 方法 选取我院2013年8月～2014年8月收治入院的采用支架联合弹簧圈栓塞技术治疗的颅内宽颈动脉瘤患者30例，围术期给予抗凝及抗血小板治疗，术后3个月复查脑血管造影评价栓塞效果。 结果 30例（30枚）颅内宽颈动脉瘤患者行Solitaire AB支架辅助弹簧圈栓塞治疗，其中26例完全致密填塞，3例填塞90%以上，1例大部分填塞（85%～90%）。并随访2～12个月，应用改良Rankin评分（mRS）进行评价，0分25例，1分4例，2分1例。其中1例因蛛网膜下腔出血诱发严重脑血管痉挛，弥漫性脑肿胀，抢救无效死亡。其余患者无栓塞术中动脉瘤破裂病例，无手术相关的支架移位、出血等并发症。宽颈动脉瘤患者支架辅助栓塞手术取得满意效果，所有患者均进行脑血管造影随访，无动脉瘤复发。 结论 Solitaire AB支架联合弹簧圈栓塞技术治疗颅内宽颈动脉瘤安全、有效。 　　[关键词] 宽颈动脉瘤；Solitaire AB支架；弹簧圈栓塞 　　[中图分类号] R743 [文献标识码] B [文章编号] 1673-9701（2015）13-0032-03 　　[Abstract] Objective To explore the clinical effects of solitaire AB stent assisted with coil embolization therapy in the treatment of wide-necked intracranial aneurysms. Methods A total of 30 patients with wide-necked intracranial aneurysms who were admitted in our hospital and given the treatment of stent combined with coil embolization technique from August 2013 to August 2014 were selected. The patients were given the treatment of anti-coagulation and anti-platelet during perioperative period. Cerebral angiography was re-examined 3 months after the surgery and embolization effect was evaluated. Results 30 patients（30 pieces） with wide-necked intracranial aneurysms were treated with solitaire AB stent assisted with coil embolization therapy in this study， among whom 26 patients were fully and closely embolised， 3 patients were embolised over 90%， and 1 patient was embolised mostly （85%-90%）. Follow-up was carried out for patients 2-12 months. Modified Rankin scores （mRS） was applied for evaluation. 25 patients were scored 0， 4 were scored 1 and 1 was scored 2. One of the patients died after rescue due to severe cerebral angiospasm induced by subarachnoid hemorrhage followed by diffuse brain swelling. No rupture of aneurysms was seen in other patients during the embolization surgery， and no surgery-associated complications such as stent displacement and bleeding. Satisfactory effect was achieved fo