Willis覆膜支架治疗颈内动脉血泡样动脉瘤15例临床分析

Willis covered stents in the treatment of intracranial blood blister-like aneurysms in 15 cases

目的探讨Willis覆膜支架系统治疗颈内动脉血泡样动脉瘤的效果及安全性。方法 15例颈内动脉血泡样动脉瘤患者均采用Willis覆膜支架治疗,其中11例择期手术,4例急诊手术治疗,共置入Willis覆膜支架18枚。结果术中18枚Willis覆膜支架均成功置入载瘤动脉,其中11例(11枚)支架置入即刻病变消失,载瘤动脉通畅;1例(1枚)置入即刻有少量造影剂滞留,1周后消失;3例分别植入2枚支架后病变消失,载瘤动脉通畅;术后随访3~6个月,患者均未发生新发梗死、出血等,改良Rankin量表(mRS)评分0分13例,1分2例;均无复发,2例载瘤动脉远端轻度狭窄,但患者无神经功能障碍。结论应用Willis覆膜支架治疗颈内动脉血泡样动脉瘤疗效确切,术后复发率低,并发症少。

Objective To explore the effect and safety of Willis covered stent system in the treatment of intracranial blood blister-like aneurysm （BBA）. Methods Eighteen Willis covered stents were implanted in 15 patients with BBA including 11 cases of selective operations and 4 of emergent operations. Results Eighteen Willis covered stents were successfully implanted into the parent artery, in which BBA in 11 cases （11 stents） disappeared immediately after the stents were implanted and the parent artery was unobstructed, while a small amount of contrast agent was found retention immediately after the stent was implanted in 1 case and disappeared 1 week later. In 3 cases, BBA disappeared after implantation of 2 stents in each patient and the parent artery was unobstructed. After follow-up for 3 to 6 months, no new infarction or hemorrhage occurred. The modified Rankin scale score was 0 in 13 cases and 1 in 2 cases. No recurrence was found. Two cases were found tumor artery distal slight stenosis, with no neurological dysfunction. Conclusion Willis covered stent is effective for BBA with low recurrence and few complications.