Enterprise支架在颈内动脉宽颈动脉瘤的应用

Application of Enterprise stents in the treatment of internal carotid artery wide-necked aneurysms

目的探讨使用Enterprise支架辅助微弹簧圈栓塞治疗颈内动脉宽颈动脉瘤的疗效和初步应用体会。方法回顾性分析13例采用Enterprise支架辅助微弹簧圈栓塞技术治疗的颈内动脉宽颈动脉瘤患者的临床资料,其中未破裂动脉瘤3例,破裂动脉瘤10例;Hunt-Hess分级:0级3例,Ⅰ级5例,Ⅱ级3例,Ⅲ级2例。结果 11例患者支架成功放置,支架不能到位1例,术中支架移位1例。术后造影见动脉瘤腔致密填塞8例,瘤颈少许残余3例,瘤体少部分显影1例。术后所有患者于3、6、12个月行DSA造影复查,8例致密栓塞的患者均未见复发,3例瘤颈少许残留病例于3、6个月复查时见瘤颈显影明显变淡,12个月复查时完全不显影,瘤体少部分显影病例于6个月复查时未见显影。所有病例载瘤动脉及分支动脉均保持通畅。结论使用Enterprise支架辅助微弹簧圈栓塞技术治疗颅内宽颈动脉瘤是一种安全有效的方法 。

Objective To investigate and summarize the technique and efficacy of endovascular Enterprise stent implantation assisted micro spring coil embolization in the treatment of internal carotid artery wide-necked aneurysms.Methods 13 cases of patients with wide-necked aneurysms who were treated by combining endovascular Enterprise stent implantation with micro spring coil placement were analyzed retrospectively.Among them aneurysms ruptured in 10 cases and unruptured in 3 cases.Hunt-Hess classification：0 level 3 cases,grade Ⅰ 5 cases,grade Ⅱ 3 cases,grade Ⅲ 2 cases.Results Enterprise stents were successfully placed in 11 cases,could＇t release in 1 case and intraoperative migrated in 1 case.Postoperative imaging revealed aneurysm cavity were densely filled in 8 cases,aneurysm neck was a little residual in 3 cases,tumor body was a few developing in 1 case.After operation,all the patients were reviewed by DSA imaging in 3,6,12 months.The 8 patients whose aneurysm cavity were densely filled did not recur;The tumor neck developing of 3 patients whose tumor neck was a little residual became weak obviously in 6 months,and the tumor neck developing of which disappeared completely in 12 months;The tumor body developing did not be found in the patient whose tumor body was a few developing in 6 months.Conclusion Combining endovascular Enterprise stent implantation with endovascular coil placement for the treatment of intracranial wide-necked aneurysms is a safe and effective treatment method.