支架植入重构载瘤动脉治疗颅内复杂动脉瘤

Stent - assisted coiling of huge and complex intracranial aneurysms

目的 探讨41例巨大及复杂颅内动脉瘤的支架植入重构载瘤动脉治疗方法以及选择不同支架结合不同型号弹簧圈栓塞动脉瘤的适应证,急性期使用支架的安全性.方法 采用Neuroform（Ⅰ、Ⅱ）、LEO以及SolitaireAB支架,弹簧圈主要采用Matrix、Orbit圈.急性期支架辅助栓塞宽颈动脉瘤28例,择期栓塞13例.结果 41例44个动脉瘤栓塞均顺利完成,无手术并发症；2例巨大动脉瘤90％栓塞,其他均95％以上栓塞.结论 支架植入重构载瘤动脉结合不同型号弹簧圈栓塞,提高了颅内巨大及复杂动脉瘤的治疗成功率；急诊栓塞时未行抗血小板聚集药物准备而使用支架,虽无相应并发症出现,但还需慎重.

Objective To explore interventional therapy for huge and complex intracranial aneurysms,and to investigate the indications of endovascular stent - assisted coiling for complex intracranial aneurysms and to evaluate the security of employing stent during operation and postoperation in acute phase.Methods Using Neuroform （ Ⅰ,Ⅱ ） LEO and SolitaireAB stent and Matrix and Orbit coils,28cases with wide - necked aneurysm were treated by stent - assisted coiling in acute period.And 13 cases were performed operation in selective phase.Results 41 cases were embolized successfully.There was no complication after operation.39 cases were 95% embolized and 2 was 90% embolized.Conclusions Stent -assisted coiling and reinstructed the neck of complex intracranial aneurysms could improve the efficacy of aneurysm treatment.Stent may be used in acute period.But the security of employing stent without anticoagulation treatment in acute perod is remained to be discussed.