支架辅助弹簧圈介入栓塞颅内宽颈动脉瘤

Stent-assisted coiling for the treatment of wide-necked intracranial aneurysms

目的探讨支架辅助弹簧圈介入栓塞治疗颅内宽颈动脉瘤的方法和疗效。方法回顾性分析16例患者的临床资料,应用支架包括Neuroform 6枚和Fnterprise 10枚。结果所有支架均成功释放并行弹簧圈栓塞,即刻造影动脉瘤获得完全及大部分栓塞13例,瘤颈残留1例,部分栓塞2例.14例患者术后3～12个月复查,13例完全及大部分栓塞中11例复查未见复发,瘤颈残留1例6个月后复查复发,再次行支架植入完全栓塞.部分栓塞2例复查时瘤腔消失。结论通过支架辅助对宽颈动脉瘤瘤颈重塑及弹簧圈的介入栓塞作用,使动脉瘤栓塞疗效满意。

Objective To explore the method and efficacy of interventional embolization with stent- assisted coiling for the treatment of wide- necked intracranial aneurysms. Methods Interventional stentassisted coiling procedure was carried out in 16 patients with wide-necked intracranial aneurysms. A total of 16 stents were used in all the procedures, including 6 Neuroform stents and 1 Enterprise stents. The clinical data were retrospectively analyzed. Results All the stents were successfully deployed and the occlusion of intracranial aneurysms with coils was accomplished in all patients. Angiography performed immediately after the procedure showed that complete or subtotal obliteration of the aneurysm was achieved in 13 cases, residue of aneurysm neck was detected in 1 case and partial embolization was seen in 2 cases. Follow- up checkups performed within 3 - 12 months after the treatment revealed that no recurrence was seen in 11 among the 13 patients who had obtained complete or subtotal occlusion of the intracranial anearysms. The patient who showed residue of aneurysm neck had a relapse at six months after the treatment. On re-examination the aneurysmal cavity disappeared in the two patients who had obtained partial embolization. Conclusion Interventional stent - assisted coiling embolization therapy is very effective for the treatment of wide - necked intracranial aneurysms.（J Intervent Radiol, 2012, 21： 501-503）