LVIS支架辅助栓塞颅内微小动脉瘤的疗效及预后随访分析

Efficacy and Prognosis of LVIS Stent Assisted Embolization for Intracranial Small Aneurysms

目的:探讨LVIS支架辅助栓塞颅内微小动脉瘤的疗效。方法:回顾性分析2015年4月至2017年4月实施LVIS支架辅助栓塞的80例颅内微小动脉瘤患者临床资料,分析手术疗效及预后情况。结果:80例患者均获得成功栓塞,成功率为100%,经术后即刻造影显示,Raymond分级I级栓塞76.25%(61/80),Ⅱ级栓塞21.25%(17/80),Ⅲ栓塞2.50%(2/80),有1例患者术中出现支架内血栓事件、2例患者术后72h内出现支架内血栓事件,发生率为3.75%(3/80),所有患者均无围术期出血、短暂或永久性神经功能缺失、死亡发生;手术至出院时间为8～23d,平均(15.48±3.94) d,出院时Hunt-Hess分级较入院时均明显改善(P<0.05);随访时间7～11个月,平均(9.34±1.24)月;随访期间Raymond分级I级栓塞的患者动脉瘤均维持稳定,无复发病例,Ⅱ级、Ⅲ级栓塞的患者无动脉瘤颈、瘤腔增长表现;mRS评分显示,75例0分,5例1～2分,随访期间无死亡病例。结论:在颅内微小动脉瘤患者中使用LVIS支架辅助栓塞效果满意,围术期并发症发生率低、远期预后较好,临床应用价值高。

Objective:To study the efficacy of LVIS stent assisted embolization for intracranial small aneurysms.Methods:Clinical data of 80 patients with intracranial small aneurysms who underwent LVIS stent-assisted embolization from April 2015 to April 2017were selected,the surgical outcome and prognosis were analyzed.Results:All 80 patients were successfully embolized,the success rate was 100%,immediate postoperative angiography showed that Raymond grade I embolism was 76.25%(61/80),grade II embolism was 21.25%(17/80),and grade III embolism was 2.50%(2/80),there was 1 cases of stent thrombosis occurred during operation,2 cases of stent thrombosis occurred after post operation 72h,the incidence was 3.75%(3/80),no perioperative bleeding,transient or permanent neurological deficits and death occurred in all patients;the time from operation to discharge was 8~23d,with an average of(15.48±3.94)d.the Hunt-Hess classification improved significantly at discharge compared with admission(P<0.05);the follow-up time was 7~11 months,with an average of(9.34±1.24)months;during the follow-up period,the patients with Raymond grade I embolization remained stable without recurrence,the patients with grade II and III embolism had no aneurysm or aneurysm;the mRS score showed that there were 75 cases in 0 scores,5 cases in 1~2 scores,and no case died during the follow-up period.Conclusion:LVIS stent assisted embolization is well for intracranial small aneurysms,the incidence of perioperative complications is low,the long-term prognosis is good,and the clinical value is high.