低剖面可视化腔内支撑支架辅助弹簧圈栓塞术治疗急性期破裂颅内宽颈动脉瘤疗效研究

Efficacy of lowprofile visualization endovascular stent assisted coil embolization in treatment of acute ruptured intracranial wide necked aneurysms

目的:探讨低剖面可视化腔内支撑支架(LVIS)辅助弹簧圈栓塞术治疗急性期破裂颅内宽颈动脉瘤的临床疗效及并发症。方法:回顾性研究实施Solitaire支架辅助弹簧圈栓塞与LVIS支架辅助弹簧圈栓塞术治疗的急性期破裂颅内宽颈动脉瘤患者108例的临床、影像学资料,其中观察组53例实施LVIS支架辅助弹簧圈治疗;对照组55例实施Solitaire支架辅助弹簧圈治疗。对比两组手术效果、并发症及患者出院时和随访6个月后的疗效。结果:术后即刻和术后12个月时观察组Raymond分级均优于对照组(P<0.05)。观察组53例中,有6例出现了围术期并发症,发生率为11.32%,对照组有15例出现相关并发症,发生率则是27.27%,两组对比有统计学差异(P<0.05)。术后随访6~14个月,平均(7.76±3.52)个月,观察组预后良好率为75.47%,对照组为56.36%,两组比较差异有统计学意义(P<0.05)。结论:LVIS支架辅助弹簧圈栓塞术在急性期破裂颅内宽颈动脉瘤患者治疗中具有较高的安全性。

Objective:To investigate the efficacy of lowprofile visualization endovascular stent(LVIS)assisted coil embolization in the treatment of acute ruptured intracranial wide necked aneurysms.Methods:The clinical and imaging data of 108 patients with acute ruptured intracranial wide necked aneurysms who received LVIS stent assisted coil embolization or Solitaire stent assisted coil embolization were retrospectively studied.The observation group was treated with LVIS stent assisted coil therapy(53 cases)and the control group was treated with Solitaire stent assisted coil therapy(55 cases).The operative effect,complications and the curative effect of the patients at discharge and after 6 months of follow-up were analyzed.Results:Raymond score of the observation group was better than that of the control group immediately after operation and 12 months after operation(all P<0.05).Of the 53 patients in the observation group,6 cases(11.32%)had perioperative complications,15 cases(27.27%)in the control group had related complications.There was a significant difference in the incidence of complications between the two groups(P<0.05).The follow-up period ranged from 6 to 14 months with an average of(7.76±3.52)months.The good prognosis rate was 75.47%in the observation group and 56.36%in the control group,and the difference was statistically significant(P<0.05).Conclusion:LVIS stent assisted coil embolization for acute ruptured intracranial wide necked aneurysms is safe and effective.