[1]张海林　周保元　谢宗志　唐　博　任小鲁　任　军　孙守元　刘吉星.套叠LVIS支架结合弹簧圈栓塞治疗颈内动脉床突上段夹层动脉瘤[J].中国临床神经外科杂志,2020,(11):737-739.[doi:doi:10.13798/j.issn.1009-153X.2020.11.001]
　ZHANG Hai-lin,ZHOU Bao-yuan,XIE Zong-zhi,et al.Overlapping LVIS stents combined with coil embolization for dissecting aneurysms of supraclinoid segment of internal carotid artery[J].,2020,(11):737-739.[doi:doi:10.13798/j.issn.1009-153X.2020.11.001]
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套叠LVIS支架结合弹簧圈栓塞治疗颈内动脉床突上段夹层动脉瘤()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年11期
页码:
737-739
栏目:
论著
出版日期:
2020-11-25

文章信息/Info

Title:
Overlapping LVIS stents combined with coil embolization for dissecting aneurysms of supraclinoid segment of internal carotid artery
文章编号:
1009-153X（2020）11-0737-03
作者:
张海林　周保元　谢宗志　唐　博　任小鲁　任　军　孙守元　刘吉星
730030 兰州，兰州大学第二医院神经外科（张海林、周保元、谢宗志、唐　博、任小鲁、任　军、孙守元、刘吉星）
Author(s):
ZHANG Hai-lin;  ZHOU Bao-yuan;  XIE Zong-zhi;  TANG Bo;  REN Xiao-lu;  REN Jun;  SUN Shou-yuan;  LIU Ji-xing.
Department of Neurosurgery, Lanzhou University Second Hospital, Lanzhou 730030, China
关键词:
颈内动脉床突上段夹层动脉瘤; 血管内治疗; LVIS支架; 弹簧圈; 支架套叠技术; 疗效
Keywords:
Dissecting aneurysm;  Supraclinoid segment of internal carotid artery;  Overlapping LVIS stents;  Coil;  Embolization
分类号:
R 743.9; R 815.2
DOI:
doi:10.13798/j.issn.1009-153X.2020.11.001
文献标志码:
A
摘要:
目的 探讨套叠LVIS支架结合弹簧圈栓塞治疗颈内动脉床突上段夹层动脉瘤的疗效。方法 回顾性分析2014年1月至2019年12月采用套叠LVIS支架结合弹簧圈栓塞治疗的43例颈内动脉床突上段夹层动脉瘤的临床资料。结果 双支架套叠40例，三支架2例，四支架1例；技术成功率100%。术后即刻造影示动脉瘤致密栓塞28例，瘤颈部残余9例，瘤体残余6例。出院时改良Rankin量表评分0~2分33例，3分5例，4~5分3例，6分2例。37例影像学随访6~26个月，动脉瘤不显影31例，改善2例，复发3例，载瘤动脉闭塞1例。结论 套叠LVIS支架辅助弹簧圈栓塞治疗颈内动脉床突上段夹层动脉瘤是一种有效的方法。
Abstract:
Objective To explore the clinical efficacy of overlapping LVIS stents combined with coil embolization for the patients with dissecting aneurysms of supraclinoid segment of internal carotid artery (DA-SS-ICA). Methods The clinical data of 43 patients with DA-SS-ICA who received overlapping LVIS stents combined with coil embolization from January 2014 to December 2019 were anapyzed retrospectively. Results Of 43 patients, 40 patients were treated with double LVIS stents, 2 with triple LVIS stents and 1 with four LVIS stents. The technical success rate was 100%. The immediate postoperative angiography showed that total occlusion of aneurysm was achieved in 28 patients, residual neck in 9 and residual aneurysm in 6. According to the modified Rankin scale (mRS) score at discharge, 33 patients had mRS score of 0~2, 5 of 3, 3 of 4~5, and 2 of 6. The results of imaging folow-up of 37 patients (range, 6~26 months) showed that the aneurysms were not seen in 31 patients, improved in 2, and recurred in 3, and the aneurysmal artery occlusion was seen in 1 patienst. Conclusions The overlapping LVIS stents combined with coil embolization for patients with DA-SS-ICA is feasible and safe. Using more stents can further reduce the risk of recurrence.

参考文献/References:

[1] 马廉亭. 颅内血泡样动脉瘤有关问题商榷[J]. 中国临床神经外科杂志，2017，22（5）：289.
[2] Peschillo S, Missori P, Piano M, et al. Blister-like aneu-rysms of middle cerebral artery: a multicenter retrospective review of diagnosis and treatment in three patients [J]. Neurosurg Rev, 2015, 38(1): 197-203.
[3] Rasskazoff S, Silvaggio J, Brouwer PA, et al. Endovascular treatment of a ruptured blood blister-like aneurysm with a flow-diverting stent [J]. Interv Neuroradiol, 2010, 16(3): 255-258.
[4] 刘　坤，周　丹，钟小康，等. 颈内动脉床突上段血泡样动脉瘤的显微手术治疗[J]. 立体定向和功能性神经外科杂志，2016，29（6）：348-350.
[5] 李　进，刘　翼，李　浩，等. 颈内动脉血泡样动脉瘤的手术治疗：单中心10年经验[J]. 中国神经精神疾病杂志，2016，42（10）：601-604.
[6] 马骏鹏，孙　鸿，游　潮，等. 颈内动脉血泡样动脉瘤手术治疗体会[J]. 四川医学，2016，37（2）：208-210.
[7] Meckel S, Singh TP, Undrén P, et al. Endovascular treatmentusing predominantly stent-assisted coil embolization and antiplatelet and anticoagulation management of ruptured blood blister-like aneurysms [J]. AJNR Am J Neuroradiol, 2011, 32(4): 764-771.
[8] Fang YB, Li Q, Wu YN, et al. Overlapping stents for blood blister-like aneurysms of the internal carotid artery [J]. ClinNeurol Neurosurg, 2014, 123: 34-39.
[9] 秦　杰，潘　力，杨　铭，等. Willis覆膜支架治疗颈内动脉血泡样动脉瘤的疗效[J]. 中国临床神经外科杂志，2018，23（4）：225-227.
[10] Rouchaud A, Saleme S, Gory B, et al. Endovascular exclu-sion of the anterior co mmunicating artery with flow-diverter stents as an emergency treatment for blister-like intracranial aneurysms: a case report [J]. Interv Neuroradiol,2013, 19(4): 471-478.
[11] ?inar C, Oran ?, Bozkaya H, et al. Endovascular treatment of ruptured blister-like aneurysms with special reference to the flow-diverting strategy [J]. Neuroradiology, 2013, 55(4): 441-447.
[12] Nerva JD, Morton RP, Levitt MR, et al. Pipeline Emboliza-tion Device as primary treatment for blister aneurysms and iatrogenic pseudoaneurysms of the internal carotid artery [J]. J Neurointerv Surg, 2015, 7(3): 210-216.
[13] Aydin K, Arat A, Sencer S, et al. Treatment of ruptured blood blister-like aneurysms with flow diverter SILK stents [J]. J Neurointerv Surg, 2015, 7(3): 202-209.
[14] 蒋海平，赵世光，史怀璋，等. 双支架错位重叠技术辅助弹簧圈栓塞治疗颈内动脉床突上段血泡样动脉瘤[J]. 中国临床神经外科杂志，2018，23（11）：708-710.
[15] Lim YC, Kim BM, Suh SH, et al. Reconstructive treatment of ruptured blood blister-like aneurysms with stent and coil [J]. Neurosurgery, 2013, 73(3): 480-488.
[16] Peschillo S, Cannizzaro D, Missori P, et al. Reconstructive endovascular treatment of a ruptured blood blister-like aneurysm of anterior co mmunicating artery [J]. J Neurosurg Sci, 2017, 61(4): 438-441.

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备注/Memo

备注/Memo:
基金项目：兰州市科技计划项目（2017-4-87）
更新日期/Last Update: 2020-11-25