支架辅助弹簧圈用于完全栓塞急性破裂颅内微小动脉瘤的疗效

Efficacy of stent-assisted coiling in completely occluding acute ruptured intracranial microaneurysm

目的观察支架辅助弹簧圈用于完全栓塞急性破裂颅内微小动脉瘤的疗效。方法回顾性分析急性破裂颅内微小动脉瘤(≤3 mm)患者38例的临床资料。其中,采用支架辅助弹簧圈栓塞(A组)治疗17例,采用单纯弹簧圈栓塞(B组)治疗21例。采用DSA或磁共振血管成像随访观察6~24个月。比较两组栓塞效果、手术并发症和术后随访情况。结果 38例动脉瘤均成功栓塞,术后即刻Raymond分级1级17例,2~3级21例。两组手术并发症和出院时改良Rankin量表(mRS) 0~2分相仿(P>0.05)。随访结果:A组影像学改善比例高于B组(P<0.05);动脉瘤完全栓塞、随访期复发、随访时mRS 0~2分及2周内死亡比例均相仿(P>0.05)。结论血管内介入治疗急性破裂颅内微小动脉瘤安全、有效。采用支架辅助弹簧圈栓塞急性破裂颅内微小动脉瘤可以促进其完全栓塞。

Objective To observe the efficacy of stent-assisted coiling in completely occluding acute ruptured intracranial microaneurysms.Methods The clinical data of 38 patients with acute ruptured intracranial microaneurysms(≤3 mm) were retrospectively analyzed.The patients were treated with stent-assisted coiling(group A,17 cases) or coiling only(group B,21 cases).The patients were followed up by DSA or MRA for 6-24 months.The efficacy of complete occlusion and complications were compared between two groups.Results All aneurysms of 38 cases were successfully embolized,of whom 17 cases were Raymond grade 1 and 21 cases were grade 2-3.There were no significant differences in surgery-related complications and the proportion of patients with modified Rankin scale(mRS) 0-2 points on discharge in both groups(P>0.05).The follow up results showed that proportion of patients with imaging improvement was higher in group A than that in group B(P<0.05).There were no significant differences in the proportion of patients with complete occlusion of aneurysm,recurrence,mRS 0-2 points and death within 2 weeks(P>0.05).Conclusion Endovascular interventional treatment for acute ruptured intracranial microaneurysms is safe and effective.The use of stent-assisted coiling for acute reptured intracranial microaneurysms can promote its complete occlusion.