支架辅助弹簧圈栓塞治疗大脑前动脉A1段起始处破裂微小动脉瘤

Stent-assisted coiling embolization for ruptured proximal anterior cerebral artery(A1)tiny aneurysms

目的探讨支架辅助弹簧圈栓塞治疗大脑前动脉A1段起始处破裂微小动脉瘤的安全性和有效性。方法回顾性分析2010~2018年支架辅助弹簧圈栓塞治疗的11例大脑前动脉A1段起始处破裂微小动脉瘤的临床资料。结果11例中,6例微导管塑形成“S”形,4例“Z”形,1例“猪尾形”。术后即刻造影显示,Raymond分级Ⅰ级9例,Ⅱ级2例。1例术后3 d出现缺血事件,出院时未遗留神经功能障碍。11例临床随访10~31个月,平均18.4个月,中位随访时间为17个月,随访期间无出血、缺血事件。11例术后6~12个月造影复查,Raymond分级Ⅰ级9例,Ⅱ级2例;临床随访改良Rankin量表评分0~2分9例,3分1例,4分1例。结论支架辅助弹簧圈栓塞是一种治疗大脑前动脉A1段起始处破裂微小动脉瘤的安全、有效的方法。

Objective To explore the feasibility,effectiveness,and safety of the stent-assisted coiling embolization for the patients with ruptured proximal anterior cerebral artery(A1)tiny aneurysms.Methods The clinical data of 11 patients with ruptured proximal anterior cerebral artery(A1)tiny aneurysms who received stent-assisted coiling embolization from 2010 to 2018 were analyzed retrospectively.Results Patient-specific catheter shaping was performed in all the patients,of whom 6 were formed to"S"shape,4"Z"shape and 1"pig tail".Raymond gradeⅠwas achieved in 9 patiens and gradeⅡin 2 immediately after the embolization.Ischemic event occurred in 1 patient 3 days after the operation,without neurological disorders on discharge.No ischemic events occurred in all the patients during the follow-up(range,10~31 months;mean,18.4 months;median,17 months).The follow-up(range,6~12 months)DSA images showed Raymond gradeⅠin 9 patiens and gradeⅡin 2.The outcomes of clinical follow-up(range,6~12 months)showed modified Rankin scale score of 0~2 in 9 patients,3 in 1,and 4 in 1.Conclusion Stent-assisted coiling embolization is a good and safe treatment method for the patients ruptured proximal anterior cerebral artery(A1)tiny aneurysms.