应用Leo支架辅助栓塞颅内复杂动脉瘤的临床观察

To investigate Leo Stent assisted coil embolization of complex intracranial aneurysms

目的应用Leo支架辅助弹簧圈栓塞颅内复杂动脉瘤，以评价该支架临床应用的可行性和适用性。方法41例患者45个复杂动脉瘤应用了44个Leo支架进行治疗，其中宽颈动脉瘤39个，梭形动脉瘤4个，夹层动脉瘤2个。结果45个动脉瘤完全栓塞31例（69％），瘤体残留8例（18％），瘤颈残留6例（13％）。44个支架全部（100％）放置满意。全部41例患者均经临床随访，29例患者31个动脉瘤行影像学随访。4例患者发生缺血性并发症，1例患者发生相邻部位脑内帆肿。结论Leo支架辅助栓塞复杂颅内动脉瘤是可行的，短期随访结果较佳，但仍需进一步的研究，以确定动脉瘤栓塞后弹簧圈的长期稳定性和支架的耐受性。

Objective Endovascular treatment of complex and broad-necked aneurysms remains a challenge for the neurovascular physician despite accelerated progress in technology and experience. The Leo stent is a new retractable self - expandable stent. The purpose of this study was to evaluate the feasibility and flexibility of the stent. Method Forty- - five complex and broad - necked intracranial aneurysms in 41 patients were treated eleetively. They were located at the cavernous carotid artery （3） , internal carotid artery ophthalmic artery segment（5）,internal carotid artery posterior communicating artery segment（23 ）, internal carotid artery bifurcation（ 1 ） , vertebral artery（ 8 ） , basilar artery （5）. Mean aneurysm size was 7. l mm. Mean neck size of aneurysms was 4. 8 ram. Results There were 31 （69%） aneurysm occlusions, 8 （ 18% ） residual aneurysms, and 6 （13%） neck remnants. Stent deployment was successful in all lesions. Clinical follow up was available in 41 patients. Angiographic follow up was available in 29 patients with 31 aneurysms. There were one thromboembolic events related to the deployment of the Leo stent, two asymptomatic parent artery occlusion, one symptomatic parent artery occlusion, and one intracerebral hematoma. Conclusions Primary treatment of complex and broad - necked intracranial aneurysms using the Leo stent is feasible and effective. Although results at follow -up are encouraging, further studies are needed to evaluate the longterm stability of aneurysmal occlusion and tolerance to the stent.