LVIS支架置入辅助弹簧圈栓塞治疗颅内宽颈动脉瘤

LVIS stents assisted coil embolization in treatment of intracranial wide-necked aneurysms

目的观察LVIS支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的疗效,并总结手术经验。方法回采用LVIS支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤患者53例(动脉瘤62个)。结果 62个动脉瘤均栓塞成功。术后即刻评价栓塞结果完全栓塞42个(68%)、近全栓塞16个(26%)、部分栓塞4例(6%),栓塞有效率94%。术中LVIS支架完全打开56例,未完全打开6例。3例患者(均为单发)出现术后并发症。LVIS支架未完全打开者术后并发症发生率高于完全打开者,P=0.015。术后随访6个月,mRS评分0分49例、1分2例、2分1例、3分1例、良好率为98%。术后6个月3个动脉瘤复发。术后即刻完全栓塞者无复发,近全栓塞者复发2例,部分栓塞者复发1例。结论 LVIS支架辅助弹簧圈栓塞术治疗颅内宽颈动脉瘤疗效满意。LVIS支架打开程度与患者术后并发症有关。

Objective To investigate the curative effect of LVIS stems assisted coil embolization in treatment of intraeranial wide-necked aneurysms, and to summarize the experience of operation. Methods Fifty-three patients （62 aneurysms） with intracranial wide-necked aneurysms treated with LVIS stents assisted coil embolization were retrospectively analyzed. Results Sixty-two aneurysms were embolized successfully. Raymond classification right after the surgery hinted grade I in 42 aneurysms （68%）, grade II in 16 aneurysms （26%）, and grade III in 4 aneurysms （6%）. In total, initial complete and near-complete obliteration were achieved in 94%. Intraoperative LVIS stents were completely open in 56 ca- ses, not completely open in 6 cases. Perioperative complications occurred in 3 patients. The incidence of complications in LVIS stents opened incompletely was higher than the LVIS stentts opened completely, P =0. 015. The patients were followed up for 6 months, mRS scored 0 in 49 cases, scored 1 in 2 cases, scored 2 in 1 case, scored 3 in 1 case, and in total the favorable rate was 98%. Three aneurysms recurred, no case recurred in Class I group, 2 cases recurred in Class Ⅱ group and 1 case recurred in Class III group. Conclusion The LVIS stents assisted coil embolization in treatment of intraeranial wide-necked aneurysms is safe and effective. The open degree of intraoperative LVIS stents is directly related to the postop- erative complications and prognosis.