国产血流导向装置在未破裂动脉瘤治疗中的研究

Study of Domestic Flow Guide Device in the Treatment of Unruptured Aneurysms

目的:针对颅内未破裂动脉瘤应用国产血流导向装置(Nuva),就其性能和疗效作一浅析和探讨。方法:以贵州省黔西市人民医院神经外科2023年2月~2023年11月收治的12例颅内未破裂动脉瘤患者为研究对象,回顾性分析使用国产血流导向装置(Nuva)治疗的临床资料,针对动脉瘤栓塞即刻效果采用Kamran分级评价,针对术后随访栓塞效果采用Raymond栓塞分级评价,预后评价采用Rankin量表(mRS)评分。结果:12例患者均为单个颈内动脉瘤,共计置入12枚血流导向密网支架,均为一次性成功,未采用辅助弹簧圈栓塞动脉瘤。采用Kamran分级评价动脉瘤栓塞即刻效果结果为:3a级7个,2a级4个,1a级1个,无支架内血栓、动脉瘤急性及亚急性破裂等并发症发生,1例双抗治疗出现牙龈出血,停氯吡格雷后症状消失,1例穿刺点并发症(假性动脉瘤),经治疗后痊愈。所有患者均随访3~6个月,平均(4.23±0.69)个月,末次随访mRS0分12例,造影复查的12例患者栓塞效果Raymond栓塞分级评价:Ⅰ级为完全栓塞10例,Ⅱ级为近全栓塞2例。结论:国产血流导向装置(Nuva)治疗颅内未破裂动脉瘤效果确切,安全可靠、但其远期效果尚需要更多临床案例进行验证。

Objective:To apply domestic flow guide device(Nuva)for intracranial unruptured aneurysm,analyze and discuss its performance and efficacy.Methods:In 12 patients with intracranial unruptured aneurysm admitted to the Neurosurgery Department of Qianxi People's Hospital of Guizhou Province from February 2023 to November 2023,the clinical data of domestic blood flow guide device(Nuva)were analyzed retrospectively,Kamran was evaluated for immediate effect of aneurysm embolization,Raymond embolization for postoperative follow-up embolization effect,and Rankin scale(mRS)for prognosis evaluation.Results:All 12 patients had a single internal carotid artery aneurysm,and a total of 12 blood flow guided dense mesh stents were implanted,all of which were successful in one attempt,without the use of auxiliary coil embolization for the aneurysm.The results of using Kamran grading to evaluate the immediate effect of arterial aneurysm embolization showed that there were 7 cases in grade 3a,4 cases in grade 2a,and 1 case in grade 1a.There were no complications such as stent thrombosis,acute or subacute rupture of the aneurysm,etc.1 case experienced gingival bleeding after dual antibody therapy,and symptoms disappeared after stopping clopidogrel.1 case had complications at the puncture site(pseudoaneurysm),which were cured after treatment.All patients were followed up for 3-6 months,with an average of(4.23±0.69)months.In the last follow-up,12 patients had an mRS score of 0.Among the 12 patients who underwent angiography review,the embolization effect was evaluated by Raymond embolization grading:10 patients had complete embolization at grade I,and 2 patients had near complete embolization at grade II.Conclusion:The domestic blood flow guide device(Nuva)is safe and reliable in treating intracranial unruptured intracranial aneurysm,but its long-term effect needs to be verified by more clinical cases.