覆膜支架在颅内动脉瘤治疗中的应用

Application of covered stents in the treatment of intracranial aneurysms

自从20世纪60年代起，血管内弹簧圈栓塞逐渐成为除开颅夹闭术之外的另一种颅内动脉瘤治疗手段，且近年来已成为许多医生的首选治疗方法。然而，颅内血管的解剖学复杂性和颅内动脉瘤的多样性使得单纯弹簧圈栓塞无法满足所有颅内动脉瘤治疗的需要，涂层弹簧圈、球囊辅助栓塞、支架辅助栓塞、覆膜支架等新材料和新技术应运而生。覆膜支架治疗颅内动脉瘤的原理是在载瘤动脉内置入一种带生物一物理屏障的支架，在保持载瘤动脉通畅的情况下，隔离动脉瘤并使其内部形成血栓，从而达到治愈病变的目的，在无重要分支血管毗邻的宽颈、巨大、夹层或假性动脉瘤等的治疗中有着较大优势。文章对覆膜支架在颅内动脉瘤治疗中的应用现状和发展前景进行了综述。

Since the 1960s, endovascular coil embolization has gradually become another treatment for intracranial aneurysms in addition to craniotomy clipping surgery, and in recent years, it has become the preferred method for many neurologists. However, the complexity of intracranial vascular anatomy and the diversity of intracranial aneurysm make the coil embolization alone unable to meet the needs of all intracranial aneurysms. And then some novel materials and techniques emerged, such as coated coils, balloon-assisted embolization, stent-assisted embolization, and covered stents. The principle of covered stents for the treatment of intracranial aneurysms is to place a kind of stents with bio-physieal barriers into the parent arteries, while maintaining the patency of the parent artery, thus isolating aneurysms, leading to thrombogenesis inside and finally curing the lesions while maintaining the patency of parent arteries. It has huge advantage in the treatment of wide-necked, huge, dissecting and pseudo aneurysms without important adjacent branch vessels. This article reviews the application situation and the prospects of development of covered stents in the treatment of intracranial aneurysms.