血管内弹簧圈栓塞治疗颅内宽颈动脉瘤的临床研究

Clinical Study of Endovascular Stent Combined with Coil for Treatment of Intracranial Wide-necked Aneurysms

目的探讨应用血管内弹簧圈栓塞治疗颅内宽颈动脉瘤的临床疗效。方法2001年5月至2007年12月,采用血管内弹簧圈治疗20例病人的20个宽颈动脉瘤,瘤颈宽度介于3￣20mm,瘤体与瘤颈直径之比介于1.5～1。围手术期均口服血小板抑制剂药物。结果20例20个弹簧圈成功到位释放,14例致密栓塞,4例瘤颈残留,2例部分栓塞。死亡1例,其余患者均恢复良好出院。临床随访19例,随访期1～6个月,平均2.3个月,无再出血及血栓栓塞症状发生。9例术后3个月血管造影随访,6例致密栓塞的动脉瘤均未显影,3例瘤颈残留者,2例无变化,1例瘤颈未再显影,提示瘤内血栓进一步形成。结论血管内弹簧圈栓塞治疗颅内宽颈动脉瘤顺应性好,安全性高,而长期疗效有待于进一步观察。

Objective To investigate the clinical effect of endovascular stent combined with coil for treatment of intracranial wide-- necked aneurysms. Methods From May 2001 to Dec 2007, twenty wide--necked aneurysms （dome to neck ratio was 1.5-1, and the neck size was 3-20mm） were treated with intracrania stent in 20 patients. All patients were treated with hemagglutination inhibitor pre--and post-operation. Results Twenty intravascular stents were successfully deployed in twenty patients. Total occlusion was achieved in fourteen patients, residual neck in four patients and partial occlusion in two patients. Nineteen patients recovered well but with one death. Nineteen patients were under clinical followed up from 1 to 6 months with an average of 2.3 months. There was no bleeding or thromboembolic events,nine patients were angiographically followed up for three months after the procedure. Among them,no filling was shown for the six aneurysms which were densely packed, other three aneurysms with neck remnant including one stable and another one with disappeared neck. Conclusions It＇ s safe and feasible of endovascular stent combined with coil in the treatment of intracranial wide-necked aneurysms, the long term effect still need to be further investigated.