摘要
目的评估支架辅助弹簧圈栓塞梭形动脉瘤术中及术后24 h内,在标准双抗血小板治疗的基础上,短期应用小剂量替罗非班在降低缺血并发症方面的安全性及有效性。方法回顾分析我中心2015年1月至2020年12月颅内未破裂梭形动脉瘤接受支架辅助弹簧圈栓塞治疗,并在手术过程中及术后24 h内静脉接受替罗非班(0.1μg/kg/min)预防血小板聚集的患者资料。记录并分析围手术期并发症,动脉瘤栓塞程度及术后3个月随访时的mRS评分。结果本研究共纳入38例患者,39枚动脉瘤,动脉瘤平均直径(6.4±2.1)mm。其中,26枚动脉瘤接受了单支架辅助弹簧圈栓塞治疗,13枚动脉瘤接受了双支架辅助弹簧圈栓塞治疗。术后即刻78.9%(30/38)的动脉瘤实现完全栓塞;在26例接受脑血管造影复查的患者中,92.3%(24/26)的患者动脉瘤实现完全闭塞。围手术期缺血并发症发生率为7.9%(3/38);无出血并发症发生。3个月随访的良好预后率为97.4%(37/38)(mRS评分为0~1分)。结论支架辅助弹簧圈栓塞梭形动脉瘤术中及术后24 h内,静脉加用小剂量替罗非班未增加出血并发症。但是,由于样本量偏少,缺少对比,在降低缺血并发症方面的有效性尚需进一步证实。
Objective To investigate the safety and efficacy of additional use of tirofiban during and within 24 h after the procedure in the treatment of intracranial fusiform aneurysms with stent-assisted coiling(SAC).Methods From January 2015 to December 2020,patients with intracranial fusiform aneurysms treated with SAC and intravenous administration of tirofiban 0.1μg/kg/min were retrospectively collected in this study.The measured end points were rates of ischemic events,intracranial hemorrhage and 3 month modified Rankin Scale(mRS).Results A total of 38 patients with 39 aneurysms were identified.Stent-assisted coiling was successful in all cases with single stent-assisted in 26 aneurysms and double stent-assisted in 13 aneurysms,achieving immediate complete aneurysm occlusion in 78.9%(30/38).At 6-month angiographic follow-up,complete aneurysm occlusion was obtained in 92.3%(24/26).Ischemic complications were observed in 7.9%(3/38)of patients.No intracranial hemorrhage was noted.Good outcomes(mRS 0-1)were observed in 97.4%(37/38)of patients at the 3-month follow up.Conclusions Additional use of tirofiban during and within 24 h after the procedure appears to be a safe treatment for fusiform aneurysms treated with SAC.
作者
韩壮
贾振宇
吴文涛
赵林波
刘圣
施海彬
Han Zhuang;Jia Zhenyu;Wu Wentao;Zhao Linbo;Liu Sheng;Shi Haibin(Department of Interventional Radiology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Nanjing 210029,China)
出处
《中华介入放射学电子杂志》
2022年第1期11-15,共5页
Chinese Journal of Interventional Radiology:electronic edition