Enterprise支架在颅内夹层动脉瘤个体化介入治疗的应用

Application of Enterprise stent in individualized interventional therapy for intracranial dissecting aneurysm

目的探讨Enterprise支架辅助弹簧圈栓塞在颅内夹层动脉瘤(IDA)介入个体化治疗中的疗效。方法回顾性分析21例IDA病例资料,根据发生部位不同分为颈内动脉系IDA和椎-基底动脉系IDA,再将椎动脉夹层动脉瘤(IVADA)以动脉瘤与小脑后下动脉(PICA)的关系及对侧椎动脉发育情况进行分型。根据分型应用Enterprise支架辅助弹簧圈栓塞治疗。结果术后即刻造影结果:完全栓塞13例,绝大部分栓塞5例,部分栓塞3例。1例基底动脉IDA,术后2 d因动脉瘤再次破裂出血死亡,1例颈内动脉IDA术后并发呼吸衰竭放弃治疗出院。19例病人获得随访DSA,其中完全栓塞14例,绝大部分栓塞3例,部分栓塞2例。结论 Enterprise支架辅助弹簧圈栓塞对IDA个体化介入治疗安全和有效。

Objective To investigate the effect of Enterprise stent-assisted coil embolization in individualized therapy for intracranial dissecting aneurysm (IDA).Methods The clinical data of 21patients with IDA were analyzed retrospectively.According to the site of occurrence,the aneurysms were divided into internal carotid artery IDA and vertebrobasilar artery IDA.The intracranial vertebral artery dissecting aneurysm (IVADA)was typed by the relationship between aneurysm and the posterior inferior cerebellar artery (PICA),and the development of the contralateral vertebral artery.Enterprise st ent-assisted coil embolization was performed based on the typing.Results Immediate postoperative angiography showed complete embolization in 13 cases,most embolization in 5 and partial embolization in 3.One patient with basilar artery IDA died of aneurysm rupture again after 2 days.One patient with internal carotid artery IDA developed respiratory failure and discharged for abandoning treatment.Nineteen patients were followed up by DSA, of whom 14 were completely embolized of aneurysm,3 mostly embolized and 2 partially embolized.Conclusions Enterprise stent-assisted coil embolization is safe and effective in individualized interventional treatment of IDA.