国产Tubridge血流导向装置治疗未破裂颅内动脉瘤

Application of domestic Tubridge flow diverter in the treatment of unruptured intracranial aneurysms

目的探讨国产Tubridge血流导向装置治疗未破裂颅内动脉瘤的效果和安全性。方法回顾性分析2018年4月至2019年1月郑州大学人民医院神经外科应用Tubridge血流导向装置治疗的23例未破裂颅内动脉瘤患者的临床资料,共33个动脉瘤。其中28个动脉瘤采用单纯Tubridge血流导向装置治疗,5个动脉瘤应用Tubridge血流导向装置联合弹簧圈栓塞治疗。采用数字减影血管造影(DSA)评估Tubridge支架的置入情况,应用Raymond分级评估动脉瘤的栓塞效果,以改良Rankin量表评分(mRS)评估患者的临床预后。结果支架置入成功率为96%(26/27)o术后2例(8.7%)发生缺血性并发症。所有患者术后随访6个月。5例患者(共11个动脉瘤)行DSA随访,其中8个动脉瘤完全不显影(Raymond I级),3个动脉瘤仍显影(Raymond DI级)。1例发生无症状性载瘤动脉狭窄。23例均获临床随访,mRS评分0分21例,1分1例,2分1例。结论应用国产Tubridge血流导向装置治疗未破裂颅内动脉瘤的短期临床预后较好,围手术期并发症少。

Objective To investigate the efficacy and safety of domestic Tubridge flow diverter in the treatment of unruptured intracranial aneurysms.Methods From April 2018 to January 2019,data were collected from 23 patients with 33 unruptured intracranial aneurysms admitted to Department of Neurosurgery,People's Hospital of Zhengzhou University.All patients were treated with domestic Tubridge flow diverter.Among them,28 aneurysms were treated with Tubridge alone and 5 were treated with Tubridge combined with coiling.Digital subtraction angiography(DSA)was used to evaluate the conditions of stent implantation.The efficacy of emobolization was evaluated by Raymond classification.Clinical outcomes were assessed based on the modified Rankin scale(mRS).Results The success rate of stent implantation was 96%(26/27).Ischemic postoperative complications occurred in 2 cases.All patients were followed up for 6 months.DSA results from 5 patients with 11 aneurysms showed that 8 aneurysms were completely occluded and nonsymptomatic stenosis of parent artery was found in 1 case.The mRS score was 0 in 21 cases,1 in 1 case and 2 in 1 case.Conclusions The short-term effect of Tubridge flow diverter in the treatment of unruptured intracranial aneurysms seems to be satisfactory with low postoperative complication rate.