超早期Neuroform支架辅助栓塞颅内破裂动脉瘤的疗效及安全性研究

Efficacy and safety of ultra-early Neuroform stent-assisted embolization in the treatment of ruptured intracranial aneurysms

目的探讨超早期Neuroform支架辅助栓塞治疗颅内破裂动脉瘤的疗效及安全性。方法回顾性分析2020年4月至2021年11月在台山市人民医院使用NeuroformEZ支架辅助栓塞治疗的30例颅内破裂动脉瘤患者的临床资料,治疗前Hunt-HessⅠ~Ⅱ级15例,Ⅲ级10例,Ⅳ级5例。于颅内动脉瘤破裂后24 h内实施NeuroformEZ支架辅助栓塞治疗。依据Raymond标准评估患者的术后栓塞状况,术后随访6个月,按照改良Rankin量表(mRS)评估患者的预后,同时统计术后并发症发生情况。结果手术完成后即刻行脑血管造影,依据Raymond标准,1级26例,2级3例,3级1例,所有患者栓塞术中及术后即刻造影均无出血并发症;随访6个月,27例完全栓塞且未复发,3例血泡样动脉瘤早期复发,经支架、微弹簧圈致密栓塞后显示完全栓塞,且2个月后复查显示未复发;mRS评分结果显示,25例恢复良好,5例预后差;术后,3例发生少量出血,均为动脉瘤子囊没有栓塞完全,2例出现偏瘫,属于脉络膜前动脉瘤。结论超早期Neuroform支架辅助栓塞颅内破裂动脉瘤疗效显著,能有效提升颅内破裂动脉瘤的愈合率,同时安全性较高,值得推广应用。

Objective To investigate the efficacy and safety of ultra-early Neuroform stent-assisted embolization in the treatment of ruptured intracranial aneurysms.Methods The clinical data of 30 patients with ruptured intracranial aneurysms treated with Neuroform EZ stent-assisted embolization in Taishan People's Hospital from April 2020 to November 2021 were retrospectively analyzed.Before treatment,there were 15 cases of Hunt-Hess gradeⅠ~Ⅱ,10 cases of gradeⅢ,and 5 cases of gradeⅣ.Within 24 hours after the rupture of the intracranial aneurysm,Neuroform EZ stent-assisted embolization was performed.The postoperative embolism status of the patients was evaluated according to Raymond's standard,and the postoperative follow-up was 6 months.The prognosis of the patients was assessed according to the modified Rankin scale(mRS),and postoperative complications were recorded.Results Cerebral angiography was performed immediately after the operation,and there were 26 cases of grade 1,3 cases of grade 2,and 1 case of grade 3,according to Raymond's standard.All patients had no bleeding complications during embolization and angiography.During the follow-up,27 cases were completely embolized without recurrence,and 3 cases of blood blister-like aneurysms recurred early and showed complete embolization after dense embolization with stents and microcoils,which showed no recurrence after 2 months at re-examination.mRS score showed that 25 cases recovered well and 5 cases had poor prognosis.After operation,3 cases had a small amount of bleeding,all of which were not completely embolized by the aneurysm ascus,and 2 cases had hemiplegia,which belonged to prechoroidal aneurysm.Conclusion Ultra-early Neuroform stent-assisted embolization of ruptured intracranial aneurysm has a significant effect.It can effectively improve the healing rate of ruptured intracranial aneurysm and has high safety,which is worthy of popularization and application.