支架辅助弹簧圈栓塞治疗出血性颅内动脉瘤的临床疗效

Clinical Effect of Stent Assisted Coil Embolization in Treatment of Hemorrhagic Intracranial Aneurysms

目的观察支架辅助弹簧圈栓塞治疗出血性颅内动脉瘤的临床疗效。方法选取2020年1月—2022年12月本院神经外科收治的36例出血性颅内动脉瘤患者为研究对象,所有患者均采用支架辅助弹簧圈栓塞治疗,统计手术选用支架类型、术后即刻Raymond分级、手术并发症和术后6个月mRS评分。结果36例出血性颅内动脉瘤患者中,Solitaire型支架占38.89%,LVIS型支架占30.56%,Enterpris型支架占25.00%,其他类型支架占5.56%;完全栓塞占72.22%,瘤颈部分未栓塞占16.67%,瘤体不完全栓塞占11.11%;术后并发症发生率为25.00%,其中血管痉挛和缺血事件发生率均为8.33%,出血事件发生率为5.56%,脑积水发生率为2.78%;痊愈占63.89%,显著好转占13.89%,轻度残疾占8.33%,中度残疾和中重度残疾占5.56%,死亡占2.78%。结论采用支架辅助弹簧圈栓塞治疗出血性颅内动脉瘤疗效确切,栓塞效果较好,并发症发生率较低,预后改善较明显。

Objective To observe clinical effect of stent assisted coil embolization in treatment of hemorrhagic intracranial aneurysms.Methods The paper chose 36 cases of hemorrhagic intracranial aneurysms in neurosurgery department of our hospital from January 2020 to December 2022,treated with stent assisted spring coil embolization.Selection of stent type,immediate Raymond grading after surgery,surgical complications,and mRS scores at 6 months after surgery were statistically analyzed.Results Among 36 cases with hemorrhagic intracranial aneurysms,Solitaire type stents accounted for 38.89%,LVIS type stents for 30.56%,Enterprise type stents for 25.00%,and other types of stents for 5.56%;complete embolization for 72.22%,non embolization of tumor neck for 16.67%,and incomplete embolization of tumor body for 11.11%.Incidence of postoperative complications was 25.00%,including 8.33%for vascular spasm and ischemic events,5.56%for bleeding events,and 2.78%for hydrocephalus.Recovery accounted for 63.89%,significant improvement accounted for 13.89%,mild disability accounted for 8.33%,moderate and moderate to severe disabilities accounted for 5.56%,and death accounted for 2.78%.Conclusion Stent assisted coil embolization can achieve definite curative effect,good embolization effect for hemorrhagic intracranial aneurysms,with low incidence of complications,which has significant prognosis improvement.