低剖面可视化腔内支撑装置(LVIS支架)辅助栓塞治疗颅内宽颈动脉瘤

Analysis of Low-profile Visualized Intraluminal Support Stent-assisted Embolization for Intracranial Aneurysms

目的探讨在颅内宽颈动脉瘤的血管内治疗中应用低剖面可视化腔内支撑装置(Low-profile Visualized Intraluminal Support,LVIS)的安全性和有效性。方法回顾性分析2015年12月～2017年8月25例颅内宽颈动脉瘤资料,其中14例为急性蛛网膜下腔出血。所有动脉瘤颈>4 mm或瘤颈体比>1/2。根据动脉瘤的瘤颈及载瘤动脉管径选择不同规格的LVIS支架,使用半释放技术释放支架。结果 25例颅内动脉瘤置入26枚支架(1例椎动脉夹层动脉瘤释放2枚),均成功释放。术后即时血管造影RaymondⅠ级23例,Ⅱ级1例,Ⅲ级1例,出院时及1个月电话随访均恢复良好,格拉斯哥结局量表(Glasgow Outcome Scale,GOS)5分。17例半年后复查脑血管造影,均无动脉瘤显影。结论对颅内宽颈动脉瘤,采用LVIS支架辅助栓塞治疗,效果明确,安全可靠。

Objective To explore the satety and efficacy of Low-prvfile Visualized Intraluminal Support （LVIS） stent-assisted embolization for intraeranial aneurysms. Methods A retrospective review of 25 patients with intraeranial aneurysms were enrolled in our hospital from December 2015 to August 2017, including 14 cases of acute subaraehnoid hemorrhage. All the aneurysms had wide necks （neck size 〉 4 mm or dome-to-neck ratio 〈 2）. The different sizes of LVIS stents were chosen based on the parent artery diameter and aneurysm neck size. Stent semi-deploying technique was performed. Results Of the 25 patients with intraeranial aneurysms, 26 LVIS stents （1 case of vertebral artery dissecting aneurysm received 2 LVIS stents） were successfully implanted （100%）. According to the Raymond grading, the immediate embolization results were grade Ⅰ in 23 cases, grade Ⅱ in 1 case, and grade Ⅲ in 1 case. The Glasgow Outcome Scale on the discharged day and 1 month after hospitalization was 5 points. After 6 months of discharge, 17 patients with cerebral angiography showed no recurrence of aneurysm. Conclusion Application of LVIS stent to endovaseular treatment of intracranial wide-neck aneurysms is sate and efficient.