网孔支架辅助弹簧圈治疗宽基底动脉瘤术中并发症的探讨

Complications of treating intracranial wild-necked aneurysms with mesh stent assisted coil embolization

目的探讨网孔支架辅助弹簧圈治疗颅内宽基底动脉瘤术中常见并发症的防治措施。方法 52例宽基底动脉癌患者(共55个动脉瘤),男性30例,女性22例,年龄41～67岁,平均50.5岁,治疗过程中分别使用了球扩式支架及自膨式支架,辅助弹簧圈栓塞宽基底动脉瘤。结果动脉瘤致密栓塞40个,部分栓塞15个;术中3例支架移位,2例弹簧圈与支架缠绕、解旋,1例支架急性血栓形成。其中死亡1例,重残1例,轻度致残1例。结论网孔支架辅助弹簧圈治疗宽基底动脉瘤虽安全可靠,但术中支架并发症不可忽视,即时处理非常重要。

Objective To summarized occasion and the prevention of complications of treating intracranial wild-necked aneurysms with mesh stent assisted coil embolization.Methods Self-expanding stent or balloon-expanding stent assisted coil embolization was performed in 52 patients with a total of 55 intracranial wild-necked aneurysms.The clinical data were retrospectively collected and analyzed.Results Total occlusion was achieved in 40 aneurysms,partly occlusion in 15 aneurysms.Complications included stent displacement in 3 patients,coil stretching in 2 patients and stent acute thrombosis in 1 patients.Conclusion The stent implantation combined with microcoil placement is a safe and effective approach for intracranial wide necked aneurysms,but the complications associated with stent should be taken seriously.