新型带纤毛弹簧圈栓塞治疗颅内动脉瘤的临床研究

A clinical study of NexusTM coils for endovascular occlusion of intracranial aneurysms

目的探讨新型带纤毛弹簧圈栓塞治疗颅内动脉瘤的临床疗效。方法南方医科大学珠江医院神经外科自2008年3月至9月共收治41例颅内动脉瘤患者（43个动脉瘤），均用新型带纤毛弹簧圈栓塞治疗。回顾性分析患者随访情况，随访时间6～12个月，行脑血管造影或CT脑血管成像或磁共振脑血管成像，了解颅内动脉瘤复发及并发症情况。结果41例患者中死亡1例，术后并发脑梗死2例，动眼神经麻痹1例，复发1例，脑积水2例；改良Rankin评分量表评级为0级9例，1级19例，2级7例，3级3例，4级1例，5级和6级各1例。结论新型带纤毛弹簧圈栓塞治疗颅内动脉瘤安全有效，对小动脉瘤（〈5mm）有相对优势，对载瘤动脉闭塞有一定优势；但对大脑前动脉、大脑中动脉等较细载瘤动脉，因纤毛的致栓作用可能会造成脑梗死．因此封闭瘤颈时应用此圈要谨慎。

Objective To analyze the effect of Nexus^TM coils for endovascular occlusion of intracranial aneurysms. Methods In 41 patients with intracranial aneurysms, endovascular occlusion of 43 aneurysms was performed using NexusTM coils. The follow-up data of the patients for 6 to 12 months were reviewed, and the imaging data from digital subtraction angiography （DSA）, CT angiography （CTA） or magnetic resonance arthrography （MRA） after the treatment were analyzed. Results In the 41 patients, 1 died, 1 had aneurysm recurrence, 3 had cerebral infarction, 1 showed ocular paralysis, and 2 developed hydrocephalus after the surgery. Evaluation with modified Rankin Scale showed grade 0 in 8 cases, grade 1 in 19 cases, grade 2 in 7 cases, grade 3 in 3 cases, grade 4 in 1 case, grade 5 in 1 case and grade 6 in 1 case. Conclusion Endovascular embolization with Nexus^TM coils is effective for treatment of intracranial aneurysms especially in cases of small aneurysms and parent artery occlusion. Caution should be taken with the coil for endovascular occlusion of the neck of anterior and middle cerebral artery aneurysms with thin parent arteries, as the fibers in the coil may cause thrombosis and potential cerebral infarction.