支架半释放技术辅助弹簧圈栓塞治疗破裂的颅内微小动脉瘤

Endovascular treatment of ruptured, tiny and wide-necked intracranial aneurysms by Semi-jailing stent-assisted coiling technique

目的探讨支架半释放技术辅助弹簧圈栓塞破裂颅内微小宽颈动脉瘤的可行性、有效性和安全性。方法 2007年1月至2011年8月采用支架半释放技术辅助弹簧圈栓塞治疗破裂颅内微小宽颈动脉瘤37例。结果所有患者均成功通过支架半释放技术辅助弹簧圈栓塞治疗。术后即刻造影结果显示,Raymond分级Ⅰ级26例,Ⅱ级8例,Ⅲ级3例。28例患者影像学随访3～24个月,平均10.4个月,未发现支架内再狭窄或复发。36例患者临床随访9～48个月,平均21.3个月,无再出血或死亡病例。结论支架半释放技术辅助弹簧圈栓塞治疗破裂颅内微小宽颈动脉瘤是安全、可行的。该技术通过增加瘤颈周围的填塞密度和改善血液动力学进一步提高长期疗效。

Objective To evaluate the feasibility, effectiveness, and safety of the embolization of the niptured, tiny and wide-necked intracranial aneurysms by semi-jailing stent-assisted coiling technique. Method Thirty-seven tiny, wide-necked and ruptured intraeranial aneurysms were endovascularly treated by the semi-jailing stent-assisted coiling technique from January, 2007 and August, 2011. Results The outcomes immediately after the embolization were Raymond class I in 26 patients, class II in 8 and class III in 3. There were no in-stent stenosis or recurrence of aneurysms in 28 patients who were followed up by the cerebral angiography from 3 to 24 months （mean, 10.4 months）. No bleeding recurred in 36 patients who were clinically followed up from 9 to 48 months （mean, 21.3 months）. Conclusions The endovascular treatment of ruptured, tiny and wide-necked intracranial aneurysms by the semi-jailing stent-assisted coiling technique is safe and feasible. The long-term curative effects of the endovascular embolization on the ruptured, tiny and wide-necked aneurysms may be further improved by the increase in the packing density and diverting blood flow produced by the semi-jailing stent-assisted coiling technique.