LVIS Jr支架辅助栓塞宽颈小脑后下动脉动脉瘤效果

CLINICAL EFFECT OF ASSISTED EMBOLIZATION WITH LVIS JR STENT IN TREATMENT OF WIDE-NECKED POSTERIOR INFERIOR CEREBELLAR ARTERY ANEURYSMS

目的了解低剖面可视化腔内支撑装置Junior型(LVIS Jr)支架辅助弹簧圈栓塞宽颈小脑后下动脉(PICA)动脉瘤的效果及安全性。方法对使用LVIS Jr支架辅助栓塞的12例病人共计12个宽颈PICA动脉瘤的临床资料进行分析,分析术中并发症、手术效果、术后6个月随访数字减影血管造影(DSA)检查结果。结果 10例破裂动脉瘤病人3d内栓塞(早期栓塞),2例未破裂动脉瘤病人择期栓塞,12例PICA动脉瘤病人均手术成功。无围手术期死亡病人,其中完全栓塞8例,瘤颈残留4例。术中发生血栓事件1例,通过微导管注入盐酸替罗非班氯化钠注射液后血栓溶解。术中发生载瘤动脉痉挛1例,通过微导管注入盐酸法舒地尔注射液后痉挛解除。术后6个月随访显示,完全栓塞10例,瘤颈残留2例,无复发;12例病人Glasgow预后评分均为5分。结论 LVIS Jr支架辅助栓塞PICA动脉瘤效果和安全性良好。

Objective To investigate the clinical effect and safety of assisted coil embolization with low-profile visualized intraluminal support Junior（LVIS Jr）stent in the treatment of wide-necked posterior inferior cerebellar artery（PICA）aneurysms.Methods A retrospective analysis was performed for the clinical data of 12 patients with 12wide-necked PICA aneurysms who underwent assisted coil embolization with LVIS Jr stent,and these data included intraoperative complications,surgical outcome,and results of digital subtraction angiography at 6-month follow-up after surgery. Results Of all patients,10 had ruptured aneurysms and underwent embolization within 3days（early embolization）,and 2had unruptured aneurysms and underwent selective embolization.All the patients underwent a successful surgery.No patients died during the perioperative period,and of all patients,8had complete embolization and 4had residual aneurysm neck.One patient experienced a thromboembolic event during surgery and thrombolysis was achieved by microcatheter infusion of tirofiban hydrochloride sodium chloride injection.Another one patient experienced the spasm of the artery with aneurysm during surgery,and the spasm was alleviated by microcatheter infusion of fasudil hydrochloride injection.The 6-month follow-up showed that 10 patients achieved complete embolization and 2had residual aneurysm neck;no patient experienced recurrence.All the patients had a Glasgow Prognostic Score of 5. Conclusion Assisted coil embolization with LVIS Jr stent is effective in the treatment of PICA aneurysms and has good safety.