单支架与双支架辅助弹簧圈栓塞颅内分叉处宽颈动脉瘤的临床价值对比分析

Comparative analysis of single stent-assisted coiling and double stent-assisted coiling embolization in the treatment of intracranial wide neck bifurcation aneurysms

目的:探讨单支架辅助弹簧圈(SSAC)和双支架辅助弹簧圈(DSAC)栓塞颅内分叉处宽颈动脉瘤(WNBA)的临床价值。方法:选取2013年1月至8月郑州大学第一附属医院收治的颅内分叉处WNBA患者109例,其中SSAC栓塞68例和DSAC栓塞41例。比较两组术中支架内血栓形成、替罗非班或依替巴肽应用情况,手术时间、费用,术后即刻Raymond-Roy闭塞分级(RROC)以及出院时改良Rankin(mRS)评分;术后3~6个月随访,比较两组支架内狭窄情况、RROC和mRS评分。结果:SSAC组术中支架内血栓形成率、手术时间、手术费用和替罗非班或依替巴肽应用率,出院时和术后3~6个月的mRS评分以及术后支架内狭窄率均低于DSAC组(P<0.05)。结论:SSAC治疗颅内分叉处WNBA支架内血栓形成和支架内狭窄率低、并发症少,且手术耗时短、费用低,更值得临床推广。

Aim:To compare the value of single stent-assisted coiling(SSAC)and double stent-assisted coiling(DSAC)embolization in the treatment of intracranial wide neck bifurcation aneurysms(WNBA).Methods:A total of 109 intracranial WNBA patients including 68 patients accepting SSAC(SSAC group)and 41 patients accepting DSAC(DSAC group)in the First Affiliated Hospital of Zhengzhou University from January 2013 to August 2023 were selected.The retrospective analysis of the 2 groups was performed on in-stent thrombosis formation,tirofiban or etoposide application,operation time and operation cost.The patients of the 2 groups were also evaluated on the Raymond-Roy Occlusion Calssification(RROC)and the modified Rankin Scale(mRS)at discharge;furthermore,the patients were reexamined on in-stent stenosis,RROC and mRS within a 3 to 6 month follow-up.Results:The in-stent thrombosis formation ratio,operation time,cost and application of tirofiban or eptifibatide during operation,the mRS score at discharge and within follow-up,and in-stent stenosis within follow-up in the SSAC group were much lower than those in the DSAC group(P<0.05).Conclusion:SSAC for treating intracranial WNBA was clinical superiority in lower stent thrombosis and in-stent stenosis,less complications,shorter surgical time,lower cost,and efficacy and is worth promoting in clinics.