血管内带膜支架在颅底血管性病变中的应用

Application of endovascular stent grafts in skull basal vascular diseases

目的探讨Jostent冠脉带膜支架对于颅底动脉瘤和颈动脉海绵窦瘘的血管内治疗效果。方法于2005年6月-2006年5月应用Jostent冠脉带膜支架治疗14例患者,包括8例颅底动脉瘤和6例颈动脉海绵窦瘘,年龄14～62岁。结果在12例患者中带膜支架被成功释放于靶动脉,导致动脉瘤或瘘完全消除并保持载瘤（瘘）动脉畅通,临床效果满意。在另两例患者中,因血管纡曲带膜支架无法到达指定位置。无手术相关并发症发生。4例患者于带膜支架放置后6个月获造影随访,显示病变未再通,载瘤（瘘）动脉畅通。结论带膜支架对于某些颅底动脉瘤和颈动脉海绵窦瘘是有用的血管内治疗手段。带膜支架的制作工艺仍有待发展和优化,以使之适用于脑血管系统。

Objective To evaluate the endovascular treatment of skull basal aneurysms and carotid-cavernous fistulae with Jostent coronary stent grafts. Methods From June 2005 to May 2006, Jostent coronary stent grafts were used to treat eight skull basal aneurysms and six traumatic carotid-cavernous fistulae in 14 patients aged from 14 to 62 years. Results The stent grafts were successfully deployed in the target arteries in 12 cases, leading to total obliteration of the aneurysms or fistulae with the parent arteries patent and favorable clinical outcomes. In the other two cases, the stent grafts could not reach the desired sites because of vascular tortuosity. No procedure-related complications occurred. Follow-up angiograms performed six months after graft deployment in four cases showed no recanalization of the lesions and normal patency of the parent arteries. Conclusion Stent graft is a useful tool for the endovascular treatment of skull basal aneurysms and carotid-cavernous fistulae in selected patients. Further research and development are needed to optimize the stent graft technology for the cerebrovascular system.