网孔支架辅助微弹簧圈治疗已破裂颅内动脉瘤的.doc

网孔支架辅助微弹簧圈治疗已破裂颅内动脉瘤的临床疗效分析 赖挺，刘俊*，杨辉，周政，李正杨（400037重庆，第三军医大学新桥医院神经外科） [摘要] 目的 探讨网孔支架辅助微弹簧圈在已破裂颅内动脉瘤栓塞治疗过程中的操控性，相关并发症及临床疗效。方法 回顾性分析应用网孔支架辅助微弹簧圈栓塞治疗60例已破裂颅内动脉瘤患者资料。结果 所有60枚支架顺利释放到位。术后即刻造影，动脉瘤获100%栓塞34个，95.0%栓塞11个，90.0%栓塞14个，80.0%栓塞1个。术中出现血管痉挛4例，动脉瘤破例3例,血栓形成1例。术后随访3～18个月，死亡2例，患者术后生存质量与术前Hunt-Hess分级之间有统计学差异(P〈0.05)。患者术后获影像学随访23例，其中DSA随访19例，1例出现支架内血管狭窄，均无动脉瘤复发。结论 使用网孔支架辅助微弹簧圈栓塞治疗已破裂颅内动脉瘤过程中，操作性良好，安全性高，疗效满意，术者娴熟的技术，对手术时机准确的把握和对介入材料正确的选择有助于减少相关并发症的发生。 [关键词] 破例颅内动脉瘤；网孔支架；微弹簧圈；血管内治疗 Clinical study on mesh stent-assisted micro-coil for treating ruptured intracranial aneurysms Lai Ting,Liu Jun,Yang Hui,Zhou Zheng,Li Zheng Yang（Department of Neurosurgery,Xingqiao hospital,Third Military Medical University,Chongqing 400037,China） [Abstract] Objective To explore the handling,complications and clinical efficacy of mesh stent-assisted micro-coil for treating ruptured intracranial aneurysms.Methods The clinical data of 60 patients with mesh stent-assisted micro-coil for treating ruptured intracranial aeurysms was analyzed.Results All 60 stents were successfully released in place. The aneurysm was 100% embolism in 34 cases, 95% embolism in 11 cases, 90% embolism in 14 cases, 80% embolism in 1 case.The complications of surgery included the Vasospasm in 4 patients , the rupture of aneurysms in 3 patients and the thrombosis in 1 patient. The all patients had been followed up for 3-18 months after surgery,and 2 of them had been died,. There were significant differences between in the patients quality of life. Between the groups of preoperative Hunt-Hess grade.The patients received postoperative imaging follow-up of 23 cases, including DSA follow-up of 19 cases. In addition to the one case appeared stent vascular stenosis and no aneurysm recurrence.Conclusion It is satisfied using mesh stent-assisted micro-coil for treating ruptured intracranial aneurysms. The stent has good compliance,therefore it can be delivered and deployed easily and positioned precisely with hi