支架辅助颅内动脉瘤栓塞术后支架内急性血栓形成的原因分析

Causes of Acute Stent Thrombosis after Stent-assisted Intracranial Aneurysm Embolization

目的:探讨支架辅助颅内动脉瘤栓塞术后支架内急性血栓形成的原因、治疗及预防措施。方法:选取2017年7月-2022年6月乳山市人民医院接受支架辅助颅内动脉瘤栓塞术治疗的颅内动脉瘤患者120例为研究对象,分析支架辅助颅内动脉瘤栓塞术后支架内急性血栓形成的原因。结果:存在高血压病史者56例中有2例(3.6%)发现血栓形成;存在糖尿病史者18例中有2例(11.1%)发现血栓形成;所用支架均为自膨式LVIS支架。3例患者症状消失,未遗留后遗症,复查颅内CT未见脑梗死灶,另有1例患者遗留肢体不全瘫痪,经3个月康复治疗后,改良Rankin量表评分1级。结论:支架辅助颅内动脉瘤栓塞术后支架内急性血栓形成的原因较多,娴熟的手术技术、积极的干预措施及准确的术前评估可减少不良事件发生。

Objective:To investigate the causes,treatment and prevention of acute stent thrombosis after stent-assisted intracranial aneurysm embolization.Methods:A total of one hundred and twenty patients with intracranial aneurysm who received stent-assisted intracranial aneurysm embolization in Rushan People's Hospital from July 2017 to June 2022 were selected as research objects to analyze the causes of acute stent thrombosis after stent-assisted intracranial aneurysm embolization.Results:Thrombosis was found in 2 cases(3.6%)of 56 patients with hypertension.Thrombosis was found in 2 cases(11.1%)of 18 patients with diabetes history.All scaffolds used were self-expanding LVIS scaffolds.Symptoms disappeared in 3 patients without residual sequelae,cerebral infarction was not found in intracranial CT reexamination,and incomplete limb paralysis was left in another patient.After 3 months of rehabilitation treatment,the modified Rankin scale score was level 1.Conclusion:There are many causes of acute stent thrombosis after stent-assisted intracranial aneurysm embolization.Skilled surgical techniques,active intervention measures and accurate preoperative evaluation can reduce the occurrence of adverse events.