支架或球囊辅助弹簧圈栓塞技术对颈内动脉宽颈后交通动脉瘤的疗效

Therapeutic evaluation of stent-assisted or balloon-assisted coil embolization in wide-necked internal carotid-posterior communicating artery aneurysms

目的评估支架或球囊辅助弹簧圈栓塞技术对颈内动脉宽颈后交通动脉瘤的治疗效果和安全性。方法回顾性分析接受支架或球囊辅助弹簧圈栓塞的47例颈内动脉宽颈后交通动脉瘤患者,其中31例采用支架辅助治疗,16例采用球囊辅助治疗。治疗后随访6~36个月,分析患者的术后造影、并发症及临床情况。结果 47例中,采用支架或球囊两种辅助治疗方法相关并发症发生率分别为9.68%（3/31）和6.25%（1/16）;手术后即刻造影显示完全栓塞率分别为58.06%（18/31）和68.75%（11/16）。31例支架辅助弹簧圈栓塞病例中随访造影18例,均无动脉瘤复发;16例球囊辅助弹簧圈栓塞病例中随访造影10例,其中3例复发。结论支架辅助弹簧圈栓塞技术和球囊辅助弹簧圈栓塞技术是颈内动脉宽颈后交通动脉瘤安全有效的治疗方法。支架辅助弹簧圈栓塞技术能够显著降低颈内动脉宽颈后交通动脉瘤的复发率,但有增加缺血事件的风险。球囊辅助弹簧圈栓塞技术的手术操作相关并发症低,术后完全栓塞率高,但复发率也相对较高。

Objective To evaluate the efficacy and safety of stent-assisted or balloon-assisted coil embolization in widenecked internal carotid-posterior communicating artery aneurysms.Methods A total of 47 patients with wide-necked internal carotid-posterior communicating artery aneurysms treated by stent-assisted or balloon-assisted coil embolization were retrospectively analyzed,i.e.31 patients underwent stent-assisted coil embolization,16 patients underwent balloon-assisted coil embolization.The angiographic results,complications and clinical manifestation were analyzed 6—36months after endovascular treatment.Results Of 47 patients with wide-necke saccular aneurysms,procedure-related complications occurred in 9.68%（3/31）with stents and 6.25%（1/16）with ballons.The percentage of complete occlusion was 58.06%（18/31）with stents and 68.75%（11/16）with ballons.Totally 18 cases were followed up with DSA in 31 cases treated with stents and no recurrence was observed,10 cases were followed up with DSA in 16 cases treated with ballons and 3recurrence aneurysms were observed.Conclusion Stent-assisted and balloon-assisted coil embolization is safety and effective in wide-necked internal carotid-posterior communicating artery aneurysms.Stent-assisted coiling augments treatment durability,but increases procedural complications.Balloon-assisted cases have higher complete occlusions rate immediately,but the recurrences rate is relatively higher as well.