LVIS与Solitaire支架辅助血管内介入治疗颅内复杂动脉瘤患者的效果比较

Comparison of effects of LVIS and Solitaire stent-assisted endovascular interventional treatment in patients with complex intracranial aneurysms

目的:比较LVIS与Solitaire支架辅助血管内介入治疗颅内复杂动脉瘤患者的效果。方法:回顾性分析2019年10月至2020年12月该院收治的89例颅内复杂动脉瘤患者的临床资料,根据使用支架不同分为观察组45例和对照组44例。两组均采用血管内介入治疗,观察组采用LVIS支架,对照组采用Solitaire支架,比较两组术后即刻及术后6个月动脉瘤栓塞程度,术前和术后6个月血清髓鞘碱性蛋白(MBP)、基质金属蛋白酶-9(MMP-9)水平,以及术后6个月预后情况[改良Rankin评分(mRS)]、并发症发生率和复发率。结果:观察组术后即刻和术后6个月Raymond分级均优于对照组,差异有统计学意义(P<0.05);术后6个月,两组血清MBP、MMP-9水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组mRS评分为(1.14±0.20)分,低于对照组的(1.79±0.36)分,差异有统计学意义(P<0.05);观察组术后并发症发生率为4.44%,低于对照组的20.45%,差异有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05)。结论:LVIS支架联合血管内介入治疗颅内复杂动脉瘤患者可提高动脉瘤栓塞程度,降低mRS评分、MBP水平、MMP-9水平和并发症发生率,效果优于Solitaire支架辅助血管内介入治疗。

Objective:To compare effects of LVIS and Solitaire stent-assisted endovascular interventional treatment in patients with complex intracranial aneurysms.Methods:The clinical data of 89 patients with complex intracranial aneurysms admitted to this hospital from October 2019 to December 2020 were retrospectively analyzed,and they were divided into observation group(45 cases)and control group(44 cases)according to different stents used.Both groups were treated with endovascular interventional treatment.The LVIS stent was used in the observation group,while the Solitaire stent was used in the control group.The degree of aneurysm embolization immediately and 6 months after the surgery,the levels of serum myelin basic protein(MBP)and matrix metalloproteinase-9(MMP-9)before and 6 months after the surgery,the 6-month prognosis[modified Rankin score(mRS)],the incidence of complications,and the recurrence rate were compared between the two groups.Results:The Raymond grade of the observation group was better than that of the control group immediately and 6 months after the surgery,and the difference was statistically significant(P<0.05).6 months after the surgery,the serum levels of MBP and MMP-9 in the two groups were lower than those before the surgery,those of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).The mRS score of the observation group was(1.14±0.20),which was lower than the control group of(1.79±0.36),and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 4.44%,which was lower than 20.45%in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in recurrence rate between the two groups(P>0.05).Conclusions:LVIS stent combined with endovascular interventional treatment in the treatment of the patients with complex intracranial aneurysm can improve the degree of aneurysm embolization,reduce the mRS score,the MBP level,the MMP-9 level and the incidence of complications.Moreover,it is superior to Solitaire stent-assisted endovascular intervention al treatment;.