Navien导引导管在颅内血管内治疗中的应用

Utilization of the Navien intracranial catheter in neuroendovascular treatment

目的 探讨Navien导引导管在颅内血管内治疗中的应用及其有效性和安全性.方法 回顾性分析2015年5月至2016年4月南昌大学第一附属医院神经外科连续应用Navien导引导管行血管内治疗的患者的临床资料,共68例,其中前循环动脉瘤43例,后循环动脉瘤18例,动静脉畸形5例,动静脉瘘1例,颈内动脉急性闭塞1例.分析其技术应用、临床疗效及相关并发症.结果 68例患者中,Navien导引导管到达颈内动脉岩骨水平段45例（66.2％）,颈内动脉海绵窦段2例（2.9％）,椎动脉V2段13例（19.1％）、V3段7例（14.7％）、V4段1例（1.5％）.术中未发生出血和缺血并发症.1例（1.5％）大脑中动脉动脉瘤患者因导引导管引起严重的血管痉挛,局部使用尼莫地平后完全缓解,后改为开颅手术夹闭.结论 Navien导引导管能够安全地进入颅内血管,为血管内治疗提供安全和稳定的操作平台.

Objective To evaluate the safety and efficacy of using a new guide catheter （Navien） in intracranial endovascular treatment.Methods We retrospectively reviewed all cases of neuroendovascular treatment during the period between May 2015 and April 2016 in our database at Neurosurgery Department of the First Affiliated Hospital of Nanchang University.A total of 68 cases involving the use of Navien guide catheter were selected.Clinical and imaging data were analyzed including the lesion location,technique for Navien advancement,intraprocedural Navien position and periprocedural complications.Results The Navien catheter was used in 68 cases,and the final position of catheter tip was in the petrous intracranial cranial artery （ICA） （45,66.2％）,cavernous ICA （2,2.9％）,vertebral artery V2 （13,19.1％）,V3 （7,14.7％） and V4 （1,1.5％）.There were no intraoperative hemorrhagic or ischemic complications.Navien-related complication occurred in 1 case of middle cerebral artery aneurysm,in which the endovascular therapy was replaced by surgical clipping because of severe catheter-caused vasospasm.Conclusion The Navien guide catheter could be safely placed into intracranial vessels and thus provide safe and stable support for endovascular therapeutic interventions.