颅内宽颈动脉瘤的血管内治疗

Endovascular therapy for intracranial wide-necked aneurysms

目的总结使用neuroform支架或球囊辅助瘤颈重塑技术与电解可脱弹簧圈结合治疗颅内宽颈动脉瘤的体会,探讨两种方法的适应症、存在问题、技术要点及临床应用前景。方法25例颅内宽颈动脉瘤中,19例采用neuroform支架置入结合电解可脱弹簧圈栓塞,6例采用球囊辅助瘤颈重塑技术结合电解可脱弹簧圈栓塞。结果以neuroform支架与电解可脱弹簧圈栓塞的动脉瘤中,10例完全闭塞,8例闭塞90%以上,1例闭塞90%以下。球囊辅助瘤颈重塑技术结合电解可脱弹簧圈栓塞的动脉瘤中,3例完全闭塞,3例闭塞90%以上。结论Neuroform支架或球囊辅助瘤颈重塑与电解可脱弹簧圈结合是治疗颅内宽颈动脉瘤的有效方法;两种方法各有优缺点,应根据宽颈动脉瘤的具体情况选择neuroform支架或球囊辅助进行栓塞。

Objective To summarize the clinical experience of treatment for intracranial wide-necked aneurysms with neuroform stent or balloon-assisted remodeling and guglielmi detachable coils in order to investigate the indications, disadvantages, technique keys and the prospect of clinical use of two methods. Methods Of 25 wide-necked aneurysms, 19 were treated by neuroform stent assisted with guglielmi detachable coils, and other 6 wide-necked aneurysms were treated by balloon assisted coiling. Results Total occlusion of the aneurysms was obtained in 10 aneurysms, over 90% in 8 aneurysms, less than 90% in 1 aneurysm among 19 wide-necked aneurysms embolized by neuroform stent and guglielmi detachable coils. Among another 6 wide-necked aneurysms embolized by balloon assisted coiling, total occlusion of the aneurysms was obtained in 3 aneurysmswhile over 90% in 3 aneurysms. Conclusion Two methods of the nettroform stent assisted and balloon-assisted coiling may be effective to treat intracranial wide-necked aneurysms. One of them should be chosen to treat wide-necked aneurysms according to their advantages and disadvantages respectively.