支架辅助、双微导管技术结合弹簧圈栓塞治疗颅内宽颈动脉瘤56例临床分析

Stent-assisted and double microcatheter technique assisted coiling in treating patients with intracranial wide-necked aneurysms： an analysis of 56 cases

目的探讨支架辅助、双微导管技术结合弹簧圈栓塞治疗颅内宽颈动脉瘤的疗效并总结临床经验。方法广州军区武汉总医院神经外科自2010年6月至2010年12月使用LEO支架辅助、双微导管技术结合弹簧圈栓塞治疗56例颅内宽颈动脉瘤患者，其中支架辅助43例，双微导管技术辅助13例，回顾性分析患者的临床资料和疗效。结果本组56例患者术后恢复良好43例（76．8％），遗留轻度神经功能障碍5例（8．9％），中度神经功能障碍6例（10．7％），死亡2例（3．6％）；64个动脉瘤中61个行血管内治疗，其中致密栓塞51个（86.3％），90％栓塞8个（13．1％），部分栓塞2个（3．3％），3个动脉瘤未治疗。结论应用支架辅助、双微导管技术结合弹簧圈栓塞治疗颅内宽颈动脉瘤，可以提高单纯弹簧圈栓塞的致密率、栓塞率，且创伤小、安全可靠、疗效良好。

Objective To explore the efficacy of stent-assisted and double microcatheter technique assisted coiling in treating patients with intracranial wide-necked aneurysms, and summarize the clinical experiences. Methods Fifty-six patients with intracranial wide-necked aneurysms, admitted to our hospital fiom June 2010 to December 2010, were treated with LEO-stent-assisted and double microcatheter technique assisted coiling （n=43 and 13, respectively）; the clinical data and efficacy of these patients were retrospectively analyzed. Results Good recovery was noted in 43 patients （76.8%）, mild neurological dysfunction in 5 （8.9%）, moderate neurological deficit in 6 （10.7%）, and death in 2 （3.6%）. A total of 61 aneurysms in 64 aneurysms were performed endovascular treatment; the angiography showed complete occlusion in 51 （86.3%）, subtotal occlusion （90%） in 8 （13.1%） and incomplete occlusion in 2 （3.3%）; 3 aneurysms were untreated. Conclusion Stent-assisted and double microcatheter technique assisted coiling is an effective, minimally invasive and safe approach in treating intracranial wide-necked aneurysms by improving the density of microcoil occlusion and the embolism percentage.