回顾性分析支架在53例脑动脉瘤介入治疗中的应用价值-神经外科学专业论文.docxVIP

摘要 摘要 万方数据 万方数据 摘要 目的： 报道运用支架结合弹簧圈或单纯支架植入治疗 53 例颅内宽颈囊状动脉瘤/ 夹层动脉瘤的结果及经验，评估该技术的安全性、有效性。 方法： 通过比较使用(Solitaire AB 支架/LEO 支架/Enterprise)支架治疗的 53 例颅内 宽颈囊状动脉瘤/夹层动脉瘤患者术前 DSA 与术后 DSA 影响学表现观察动脉瘤 栓塞效果、动脉瘤复发状况、载瘤动脉通畅情况，评价支架在脑动脉瘤介入治 疗中的应用价值。 结果： 所有患者行脑血管造影随访 6-26 个月，平均随访时间 10.5 个月。46 例囊状 动脉瘤中 44 例动脉瘤栓塞致密无显影，1 例行单纯支架植入的前交通微小动脉 瘤瘤体还有轻微显影，1 例大脑中动脉分叉部动脉瘤颈口轻微再通；7 例夹层动 脉瘤中瘤体再通 4 例，余 3 例栓塞良好。并发症：术后 1 例患者出现症状性脑 梗塞，1 例后交通动脉瘤患者并发大脑中动脉 M1 段支架内狭窄，2 例后交通动 脉瘤患者并发颈内动脉末端闭塞，所有患者均无再次出血，无死亡病例。 结论： 支架结合弹簧圈栓塞是治疗颅内囊状宽颈动脉是安全有效的方法，可以有 效减少复发率，提高长期治愈率；单纯支架植入给颅内微小动脉瘤特别是超微 小动脉瘤的治疗提供了一种新的选择；夹层动脉瘤术后的高复发率值得研究； 支架植入后引发的载瘤动脉闭塞或狭窄原因有待进一步研究。 关键词：囊状宽颈动脉瘤；夹层动脉瘤；血管内治疗；支架 II Abst Abstract ABSTRACT Objective Reported use of stent combined with spring ring or simple Stenting in treatment of 53 cases of intracranial wide-necked saccular aneurysm/dissection results and experience to assess the technology of safety and effectiveness. Methods By comparing the Solitaire AB bracket/LEO bracket/Enterprise stent in the treatment of 53 patients with wide neck intracranial saccular aneurysms/dissections in patients before observation on effects of DSA and DSA manifestation aneurysm embolism artery patency effect, contained in, the evaluation role of stent in intracranial aneurysms interventional therapy to assess the technology of safety and effectiveness. Results Cerebral angiographic follow-up 6-26 months in all patients, with an average follow-up time of 10.5 months。46 cases of saccular aneurysm: report of 44 cases of aneurysm embolism in tight no developer，1 patients with middle cerebral artery bifurcation aneurysm neck slightly recanalization ， 1 patients with posterior communicating aneurysm complicated with M1 segment of middle cerebral artery in-stent stenosis，2 patients with posterior communicating aneurysm complicated with occlusion of internal carotid artery to the end；7 cases of body by a modified 4 cases of dissecting aneurysm, 3 cases of embolism in good. 1 cases of symptoms in patients with cerebral infar