摘要
目的观察Solitaire AB支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤初中期效果。方法回顾性分析2009年至2012年期间采用Solitaire AB支架辅助弹簧圈栓塞治疗的49例颅内宽颈动脉瘤患者49个动脉瘤,其中41例患者41个动脉瘤(26个破裂出血,15个未破裂)术后随访12~48个月,根据改良Rankin评分、DSA、CTA或MRA检查评价颅内动脉瘤影像学及临床结果。结果栓塞术后有2例动脉瘤再次破裂出血,3例脑梗死,1例载瘤动脉闭塞,死亡1例,并发症发生率为14.2%。栓塞术后12个月DSA、MRA或CTA检查显示,32个动脉瘤(32/41,78.0%)完全栓塞,明显高于术后即刻(21个,42.9%)(P=0.02);瘤颈残留7个(17.1%),部分栓塞2个(4.9%),均较术后即刻有改善。24个动脉瘤(58.5%)稳定而无变化,复发4个(9.7%)。末次随访时改良Rankin评分显示0分18例(43.9%),1分10例(24.4%),2分5例(12.2%),3分4例(9.8%),4分2例(4.85%),5分2例(4.85%)。患者日常活动能力自理率为80.5%,预后良好。结论 Solitaire AB支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤安全有效,有助于提高完全栓塞率,降低操作相关并发症。
Objective To investigate the mid- term effect of Solitaire AB stent- assisted interventional embolization with spring coils for the treatment of intracranial wide- necked aneurysms. Methods During the period from May 2009 to April 2013, a total of 49 patients with intracranial wide- necked aneurysm(49aneurysms in total) received Solitaire AB stent-assisted interventional embolization treatment at authors' hospital.In 41 patients, a total of 41 aneurysms were detected, of which ruptured aneurysm with bleeding was confirmed in 26 and un- ruptured aneurysm in 15. These 41 patients were followed up for 12-48 months.Based on modified Rankin scoring and DSA, CTA or MRA manifestations, the clinical results were evaluated.Results After the embolization treatment, re-bleeding of the aneurysm occurred in 2 cases, cerebral infarction in 3 cases, occlusion of the parent artery in one case and death in one case; the occurrence rate of complications was 14.2%. DSA, MRA or CTA performed at 12 months after the embolization treatment,showed that 32 aneurysms(78.0%) were completely obstructed, which was obviously higher than that observed on DSA performed immediately after the embolization procedure(21 aneurysms, 42.9%), the difference was statistically significant(P=0.02); residue of aneurismal neck was seen in 7 cases(17.1%) and partial occlusion in 2 cases(4.9%), which were much better than those observed on DSA that was performed immediately after the embolization procedure. Twenty- four aneurysms(58.5%) remained stable, showing no any change, and recurrence of aneurysm was observed in 4 cases(9.7%). At the last follow- up exam, the modified Rankin scoring showed that 0 point was seen in 18 cases(43.9%), one point in 10 cases(24.4%), 2 points in 5 cases(12.2%), 3 points in 4 cases(9.8%), 4 points in 2 cases(4.85%) and 5 points in 2 cases(4.85%). The self- care rate for daily activities was 80.5%, the prognosis was good. Conclusion For the treatment of intracranial wide- necked aneurysms, Solitaire AB stent- assisted interventional embolization with spring coils is safe and effective. This technique can improve the embolization rate and reduce the procedure- related complications.
出处
《介入放射学杂志》
CSCD
北大核心
2015年第4期282-286,共5页
Journal of Interventional Radiology
关键词
颅内动脉瘤
支架
弹簧圈
栓塞
随访研究
intracranial aneurysm
stent
steel coil
embolization
follow-up study