支架辅助弹簧圈栓塞在急诊栓塞颅内宽颈微小动脉瘤破裂中的应用

Application of emergency stent-assisted coil embolization in treatment of very small wide-necked intracranial aneurysm rupture

目的探讨支架辅助弹簧圈栓塞在治疗急诊治疗颅内破裂宽颈微小动脉瘤（最大径≤3mm）中的操作技巧及临床疗效。方法回顾急诊支架辅助弹簧圈栓塞治疗的7例颅内破裂宽颈微小动脉瘤患者资料，分析治疗方法、疗效、并发症、预后及6～12个月随访结果，评价支架技术的安全性、有效性及操作技巧。结果术后即刻造影显示，完全栓塞5例，次全栓塞1例，单纯植入支架1例；未发生破裂出血及血栓栓塞事件。术后3个月改良式格拉斯哥预后评分（GOS）结果显示，6例恢复正常，1例恢复良好。6～12个月随访未发现动脉瘤再破裂出血。结论支架辅助弹簧圈急诊栓塞治疗颅内破裂宽颈微小动脉瘤安全有效。

Objective To explore the skills and clinical effect of emergency endovascular stent-assisted coil embolization of very small wide-necked aneurysm （max diameter 43 mm） rupture. Methods Seven patients with very small wide-necked aneurysm rupture treated emergently with stent-assisted coil embolization were analyzed retrospectively. The skills of em- bolization, therapeutic effect, procedural complications, the immediate angiographic outcome after coiling, the clinical out- come and 6--12 months follow-up results were assessed. Results Cerebral angiography performed immediately after treat- ment showed that complete occlusion of aneurysm was achieved in 5 patients, subtotal occlusion in 1 patient, while only stent implantation in the rest one patient. During the procedure, no bleeding due to aneurysm rupture nor cerebral embol- ism events occurred. Three months after coil embolization, according to the results of Glasgow outcome scale, 6 patients recovered to normal, while 1 recovered well. No rebleeding occurred during follow-up. Conclusion Emergency endovascu- lar stent-assisted coil embolization is safe and effective for treatment of very small wide-necked aneurysm rupture.