Willis覆膜支架系统治疗血泡样动脉瘤的效果

Effect of Willis stent graft system in the treatment of blood bubble like aneurysms

目的探讨Willis覆膜支架系统治疗血泡样动脉瘤的安全性及远期效果。方法选取我院2015年6月～2017年6月收治的9例血泡样动脉瘤患者作为研究观察对象,共9枚动脉瘤。患者均行Willis覆膜支架系统治疗,统计患者的手术结果 ,采用美国国立卫生院神经功能缺损量表(NIHSS)评价患者手术前后及术后1年的神经功能缺损情况;评估手术安全性,随访1年,统计患者的复发率。结果 9例患者中有7例患者均一次成功置入支架,一次成功率为77.78%,1例患者置入支架后出现内漏现象,再置入1枚支架后,DSA造影显示动脉瘤消失;还有1例患者由于动脉血管比较迂曲,置入过程中支架脱落,利用微导丝把支架取出后换用较短的覆膜支架,成功置入。患者术后的NIHSS评分为(5.04±2.53)分,低于术前的(7.49±2.49)分,差异有统计学意义(P<0.05)。9例患者中有1例患者由于微导丝刺破血管出现出血,行相应治疗后顺利恢复。术后随访1年,患者均无复发,有1例患者经DSA复查发现载瘤动脉出现轻度狭窄,但不影响神经功能。术后1年,患者的NIHSS评分为(4.72±2.32)分,与术后比较,差异无统计学意义(P>0.05)。结论采用Willis覆膜支架系统治疗血泡样动脉瘤的安全性高,远期效果好,值得推广。

Objective To explore the safety and the long term effect of Willis stent graft system in the treatment of blood bubble like aneurysms.Methods From June 2015 to June 2017,9 patients with blood bubble like aneurysms admitted to our hospital were selected as the study objects,with a total of 9 aneurysms.All patients were treated with Willis stent graft system.The surgical results were counted.The neurological deficits before and after surgery and 1 year after surgery were assessed by national insitute of health stroke scale(NIHSS).The safety of surgery was evaluated,and the recurrence rate was calculated after 1 year of follow-up.Results In 9 patients,stents were successfully implanted in 7 patients at one time,with a success rate of 77.78% ,and 1 patient had endoleak after stent implantation.DSA showed that aneurysms disappeared after stent implantation.Another 1 patient had stent shedding during stent implantation due to tortuous arterial vessels.After stent removal,a shorter covered stent was successfully implanted.The NIHSS score after operation was(5.04±2.53)points,which was lower than(7.49±2.49)points before operation,and the difference was statistically significant(P<0.05).Among the 9 patients,1 patient had bleeding due to microwire puncture of blood vessels,and recovered smoothly after corresponding treatment.All patients were followed up for 1 year without recurrence.A toal of 1 patient was found to have slight stenosis of the parent artery by DSA reexamination,but it did not affect nerve function.One year after operation,the NIHSS score of the patients was(4.72±2.32)points,and there was no significant difference compared with the preoperative score(P>0.05).Conclusion Willis stent graft system is safe and effective in the treatment of blood bubble like aneurysms which is worthy of promotion.