血管内支架治疗颅内、外动脉狭窄和颅内宽颈动脉瘤

The Treatment of Cranial Arterial Stenosis and Intracranial Wide Neck Aneurysm with Endovascular Stent

目的探讨血管内支架治疗颅内、颅外动脉狭窄以及颅内宽颈动脉瘤的安全性和有效性。方法应用血管内支架成形治疗14例颅内、颅外动脉狭窄;支架结合弹簧圈栓塞治疗颅内宽颈动脉瘤5例,单纯支架置入治疗颅内宽颈动脉瘤1例。结果14例颅内、外动脉狭窄,经支架成形治疗后10例血管直径恢复正常,4例血管直径恢复85%～90%。6例颅内宽颈动脉瘤,4例获得致密栓塞,1例疏松栓塞,1例单纯支架置入后动脉瘤腔内血流滞留。术中发生支架移位1例。随访1～36月,无发生缺血或出血性事件,10例定期血管造影检查未发现支架再狭窄或闭塞,动脉瘤无复发。结论应用血管内支架治疗颅内、颅外动脉狭窄以及辅助弹簧圈治疗颅内宽颈动脉瘤是安全、可行、有效的。

Objective To investigate the security and efficacy in the treatment of intra- and extracranial arterial stenosis and intracranial wide neck aneurysm with endovascular stent. Methods Angioplasty with intravascular stent was performed in fourteen patients with intra- and extra-cranial stenosis, six cases with intracranial wide neck aneurysm were angioplasty with intravascular stent combined with coil embolization. Results In ten of the fourteen cases with intra- and extra-cranial arterial stenosis, the blood vessel diameter restored to normal level, while in the other four restored to about 85%-90% of normal level. Of the six cases with wide neck aneurysm, intense embolization was accomplished in four; loose embolization in one, and in the other one case, intra-aneurysmal blood flow stagnated after intravascular stent was applied. No intraoperative complication occurred, except for stent shift in one case. Ischemic or hemorrhagic event did not happen in any case after a follow up of one to thirty six months. Vascular re-stenosis or occlusion was not discovered with periodical angiography in ten cases, and there was no aneurysm recurrence. Conclusion The application of endovascular stent is safe, practicable and efficient for the treatment of intra- and extra-cranial arterial stenosis, and intracranial wide neck aneurysm with the aid of coils.