支架精显技术指导支架辅助弹簧圈栓塞颅内动脉瘤

Stent precision technique to guide stent-assisted coil embolization of intracranial aneurysms

目的观察支架精显技术指导颅内支架辅助弹簧圈栓塞动脉瘤的效果。方法选择2020-01-2022-01济宁医学院附属医院神经外科收治的92例颅内动脉瘤患者,随机数字表法将患者分为2组,对照组(n=46)在数字减影血管造影技术(DSA)指导下采用支架辅助弹簧圈栓塞治疗,观察组(n=46)在支架精显技术指导下采用支架辅助弹簧圈栓塞治疗。对比2组手术时间、成像质量、栓塞效果、神经预后、并发症和复发情况。结果观察组手术时间短于对照组[(1.05±0.20)h比(1.61±0.32)h,P<0.05],镍钛金属丝伪影评分低于对照组[(1.06±0.20)分比(1.23±0.21)分,P<0.05],镍钛金属丝显影、双螺旋显影评分高于对照组[(1.32±0.25)分比(0.95±0.16)分,(1.52±0.32)分比(1.31±0.21)分,P<0.05],动脉瘤栓塞效果优于对照组(P<0.05),术后6个月末次随访改良Rankin量表(mRS)评分[(2.20±0.38)分比(2.42±0.39)分,(2.25±0.36)分比(2.52±0.41)分,P<0.05]及脑梗死、颅内动脉瘤复发发生率(0比8.89%、0比11.11%)低于对照组(P<0.05)。结论支架精显技术指导颅内支架辅助弹簧圈栓塞动脉瘤可提高支架可视度和栓塞效果,降低脑梗死并发症和颅内动脉瘤复发风险,改善患者神经预后。

Objective To observe the effect of stent precision technique in guiding intracranial stent assisted coil embolization of aneurysms.Methods A total of 92 patients with intracranial aneurysm admitted to the Neurosurgery Department of Affiliated Hospital of Jining Medical University from January 2020 to January 2022 were selected and divided into two groups by random number table method.The control group(46 cases)received stent-assisted embolization with spring coil under the guidance of DSA.Observation group(46 cases)received stent-assisted embolization with spring coil under the guidance of stent precision technique.Operative time,imaging quality,embolization effect,neurological prognosis,complications and recurrence were compared between the two groups.Results The operation time of the observation group was shorter than that of the control group((1.05±0.20)h vs(1.61±0.32)h,P<0.05),and the pseudo-film score of nickel-titanium wire was lower than that of the control group((1.06±0.20)points vs(1.23±0.21)points,P<0.05).The score of Ni-Ti wire and double helix development in the observation group was higher than that of control group((1.32±0.25)points vs(0.95±0.16)points,(1.52±0.32)points vs(1.31±0.21)points,P<0.05),and the effect of aneurysm embolization in the observation group was better than that of control group(P<0.05).The modified Rankin scale(mRS)score((2.20±0.38)points vs(2.42±0.39)points,(2.25±0.36)points vs(2.52±0.41)points,P<0.05)at the six-month follow-up after surgery,the recurrence rate of cerebral infarction and intracranial aneurysm(0 vs 8.89%,0 vs 11.11%)in the observation group lower than control group(P<0.05).Conclusion Stent-assisted coil embolization can improve the visibility and embolization effect of the stent,reduce the complications of cerebral infarction and the risk of intracranial aneurysm recurrence,and improve the neurological prognosis of patients.