Pipeline密网支架治疗颅内复杂动脉瘤的短期疗效

Short-term curative effect of Pipeline embolization device on complex intracranial aneurysms

目的探讨Pipeline密网支架治疗颅内复杂动脉瘤的短期效果。方法回顾性分析南方医科大学南方医院神经外科2015~2016应用Pipeline密网支架治疗的16例颅内复杂动脉瘤的临床资料。结果 16例19个动脉瘤,置入Pipeline密网支架20枚,其中4例置入2枚支架,其余12例置入1枚支架。单纯行Pipeline密网支架治疗11例,联合弹簧圈栓塞治疗5例(其中包括2例蛇形动脉瘤)。所有病人术中即刻造影见瘤腔内对比剂明显滞留,载瘤动脉通畅无狭窄。14例17个动脉瘤术后随访3~12个月,平均7.1个月;12个动脉瘤治愈,4个动脉瘤改善,1例动脉瘤治疗无效;2例动脉轻度狭窄(≤30%),但无临床症状。结论应用Pipeline密网支架治疗颅内复杂动脉瘤短期安全有效,但仍需要更多样本量和更长时间的随访以进一步验证。

Objective To observe the short-term curative effect of Pipeline embolization device（PED） on complex intracranial aneurysms. Methods The clinical data of 16 patients with 19 complex intracranial aneurysms treated with PED in the Department of Neurosurgery, Nanfang Hospital, Southern Medical University from 2015 to 2016 were analyzed retrospectively, including surgical modalities, complications, imaging findings and so on. Results Of 16 patients, 4 received the implantation of 2 PED each and 12 implantation of 1 PED each; 11 were treated with PED alone and 5 including 2 with serpentine aneurysms with PED combined with coils. The intraoperative angiography immediately after the impantation of PED showed that the contrast agents were obviously stranded in the aneurysm cavities and the parent arteries were free without stenosis in all the patients. DSA follow-up 3-12 months（mean, 7.1 months） after the operation showed that of 17 aneurysms in 14 patients, 12 were cured, 4 shrank and 1 was unchanged. Two patients with mild stenosis（≤30%） of the parent arteries had no clinical symptoms. Conclusion The treatment of complex intracranial aneurysms with PED is safe and effective, but its safety and effect requires further validation by treatment of more patients and longer term following-up.