颅内动脉瘤血流导向装置治疗后迟发性脑实质出血

Delayed intraparenchymal hemorrhage following treatment of intracranial aneurysms with flow diverter

血流导向装置(flow diverter,FD)是颅内动脉瘤的血管内治疗方式之一。迟发性脑实质出血(delayed intraparenchymal hemorrhage,DIPH)是FD术后的一种严重并发症,可能导致严重神经功能恶化、转归不良甚至死亡。DIPH的发生机制目前尚不完全清楚,可能与动脉瘤的形态学特征、血流动力学改变、术后缺血性病灶的出血性转化、药物治疗方案以及免疫炎症反应等因素相关。文章对颅内动脉瘤FD术后DIPH进行综述,以期为围手术期管理提供参考。

Flow director(FD)is one of endovascular treatment methods for intracranial aneurysms.Delayed intraparenchymal hemorrhage(DIPH)is a serious complication after FD,which may lead to severe neurological deterioration,poor outcome,and even death.The mechanism of DIPH is currently not fully understood and may be associated with factors such as the morphological characteristics of the aneurysm,hemodynamic changes,hemorrhagic transformation of postoperative ischemic lesions,drug treatment regimens,and immune inflammatory response.This article reviews the DIPH following treatment of intracranial aneurysms with FD,in order to provide reference for perioperative management.