Solitaire AB与Enterprise支架辅助栓塞颅内宽颈动脉瘤患者的疗效对比

Efficacy comparison of Solitaire AB and Enterprise stent-assisted embolization of intracranial wide-necked aneurysms

目的比较Solitaire AB与Enterprise支架对血管内辅助栓塞颅内宽颈动脉瘤的效果。方法回顾性分析广东省人民医院2012年1月至2014年12月采用Solitaire AB或Enterprise支架治疗的218例颅内宽颈动脉瘤患者的临床资料。其中使用Solitaire AB支架治疗（Solitaire AB组）70例,Enterprise治疗（Enterprise组）148例。随访时间为术后2个月至2年,以术后Raymond分级和改良Rankin量表（mRS）评分对两种支架的疗效进行比较。结果术前两组患者Hunt-Hess分级（Z=1.550,P=0.121）、Fisher分级（Z=1.537,P=0.124）、动脉瘤大小（Z=0.192,P=0.848）和部位（χ-2=0.337,P=0.736）差异均无统计学意义。术后两组患者即刻Raymond分级（Z=0.682,P=0.495）、随访Raymond分级（Z=0.206,P=0.837）和mRS评分（P=0.662）比较,差异均无统计学意义。进一步行多因素Logistic回归分析,显示支架种类不是影响预后的因素[随访Raymond分级（OR=0.029,95%CI：0.126-0.199,P=0.661）和术后mRS评分（OR=2.000,95%CI：0.204-19.603,P=0.552]。结论 Solitaire AB和Enterprise支架辅助栓塞颅内宽颈动脉瘤效果均良好。

Objective To compare the effect of Solitaire AB and Enterprise stent-assisted endovascular embolization of intracranial wide-necked aneurysms. Methods The clinical data 218 patients with intracranial aneurysm treated with Solitaire AB stent or Enterprise stent in Guangdong General Hospital from January 2012 to December 2014 were analyzed retrospectively. Seventy patients were treated with Solitaire AB stents and 148 were treated with Enterprise stents. They were followed up after procedure（ 2 months to 2 years）. The Raymond grade and the modified Rankin scale（ mRS） scores were used to compare the efficacy of the 2 kinds of stents. Results There were no significant differences in patients before procedure in the Hunt-Hess grade（ Z = 1. 550,P = 0. 121）,Fisher grade（ Z = 1. 537,P = 0. 124）,aneurysm size（ Z =0. 192,P = 0. 848）,and position（ χ-2= 0. 337,P = 0. 736） between the 2 stent groups,while there were no significant differences in patients after procedure in the instant Raymond grade（ Z = 0. 682,P = 0. 495）,follow-up Raymond grade（ Z = 0. 206,P = 0. 837）,and mRS score（ P = 0. 662） between the 2 stent groups.Further multivariate Logistic regression analysis showed that the stent type（ Solitaire AB stent or Enterprise stent）,Raym ond grade follow-up grade（ OR,0. 0 2 9,95 % CI 0. 126- 0. 199,P = 0. 661）,and postoperative mRS score（ OR,2. 000,95 % CI 0. 204- 19. 603,P = 0. 552） had no influence on the prognosis. Conclusions In the assisted embolization of intracranial wide-necked aneurysms using the Solitaire AB and Enterprise stents,the effects of both stents are good in the assisted embolization of intracranial wide-necked aneurysms.