LVIS支架释放前后颅内动脉瘤瘤腔内压力变化的研究

Clinical study on changes of intracavitary pressure of intracranial aneurysms before and after LVIS stent release

目的探讨LVIS支架辅助栓塞颅内动脉瘤术中,支架释放前后动脉瘤瘤腔内压力的变化。方法对40例颈内动脉海绵窦段至颈内动脉末端未破裂动脉瘤患者行LVIS支架辅助栓塞术,术中将Echelon10微导管连接压力传感器送至动脉瘤腔内,测量支架释放前后动脉瘤腔内的压力值,并同时测量平均动脉压(MAP)。比较支架释放前后动脉瘤腔内压力与MAP的比值。结果本组患者的LVIS支架释放成功率为100%。支架释放前后的动脉瘤腔内压力与MAP的比值分别为(0.894±0.064)和(0.953±0.059),支架释放后动脉瘤腔内压力与MAP的比值明显高于支架释放前,差异有统计学意义(t=-14.029,P<0.001)。结论LVIS支架辅助栓塞颅内动脉瘤术中,支架释放后的动脉瘤瘤腔内压力比支架释放前明显增高。其原因可能为支架释放后引起的血流动力学变化所致。

Objective To investigate the changes of intra aneurysm pressure before and after stent release during LVIS stent assisted embolization of intracranial aneurysms.Methods 40 patients with unruptured aneurysms from the cavernous sinus to the end of internal carotid artery were treated with LVIs stent assisted embolization.The echelon 10 microcatheter was connected with a pressure sensor and sent to the aneurysm cavity.The pressure value in the aneurysm cavity before and after stent release was measured,and the mean arterial pressure(MAP)was measured at the same time.The ratio of intra aneurysm pressure to MAP before and after stent release was compared.Results The success rate of LVIs stent release was 100%.The ratio of intra aneurysm pressure to MAP before and after stent release was(0.894±0.064)and(0.953±0.059).The ratio of intra aneurysm pressure to MAP after stent release was significantly higher than that before stent release,and the difference was statistically significant(t=-14.029,P<0.001).Conclusions During LVIS stent assisted embolization of intracranial aneurysms,the pressure in the aneurysm cavity after stent release was significantly higher than that before stent release.The reason may be the hemodynamic changes after stent release.