[1]胡 骁 周林裕 王 克 邓剑平 赵振伟.支架辅助血管内栓塞前交通动脉破裂动脉瘤的疗效[J].中国临床神经外科杂志,2016,(02):82-84.[doi:10.13798/j.issn.1009-153X.2016.02.007]
 HU Xiao,ZHOU Lin-yu,WANG Ke,et al.Curative effect of stent-assisted endovascular embolization on ruptured anterior communicating artery aneurysms[J].,2016,(02):82-84.[doi:10.13798/j.issn.1009-153X.2016.02.007]
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支架辅助血管内栓塞前交通动脉破裂动脉瘤的疗效()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年02期
页码:
82-84
栏目:
论著
出版日期:
2016-02-25

文章信息/Info

Title:
Curative effect of stent-assisted endovascular embolization on ruptured anterior communicating artery aneurysms
文章编号:
1009-153X(2016)02-0082-03
作者:
胡 骁 周林裕 王 克 邓剑平 赵振伟
723000 陕西汉中,三二〇一医院神经外科(胡 骁、周林裕、王 克);710038 西安,第四军医大学唐都医院神经外科(邓剑平、赵振伟)
Author(s):
HU Xiao1 ZHOU Lin-yu1 WANG Ke1 DENG Jian-ping1 ZHAO Zhen-wei2.
1. Department of Neurosurgery, SAN ER LING YI Hospital, Hanzhong 723000, China;
2. Department of Neurosurgery, Tangdu Hospital, The Fourth Millitary Medical University, Xi’an 710038, China
关键词:
颅内破裂动脉瘤前交通动脉血管内栓塞弹簧圈支架疗效
Keywords:
Aneurysms Anterior communicating artery Endovascular embolization Coils Stents
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2016.02.007
文献标志码:
A
摘要:
目的 探讨支架辅助栓塞前交通动脉破裂动脉瘤的技术及临床疗效。方法 2005年7月至2015年4月采用支架辅助血管内栓塞治疗前交通动脉破裂动脉瘤21例。结果 栓塞后即刻造影示完全栓塞15例,瘤颈部分残留6例。术中动脉瘤破裂1例,术后再出血2例。21例患者术后随访6~24个月,平均12个月,其中DSA随访15例(9例即刻完全栓塞的患者造影复查动脉瘤仍完全不显影,载瘤动脉通畅;6例栓塞即刻大部分栓塞患者5例动脉瘤级瘤颈未显影,1例瘤颈仍部分显影;术后支架移位2例,载瘤动脉轻度狭窄1例);所有患者均无神经功能损伤。结论 采用支架辅助血管内栓塞治疗前交通动脉破裂动脉瘤是安全的,复发率低,规范的操作、栓塞材料的合理选择可以降低手术并发症,达到最佳的临床疗效。
Abstract:
Objective To investigate the technique of stent-assisted endovascular embolization of anterior communicating artery (ACoA) aneurysms and its clinical effect. Method The clinical data of 21 patients with ACoA aneurysms, which were confirmed by DSA and treated by stent-assisted endovascular embolization from July, 2005 to April, 2015, were analyzed retrospectively, including the technical keys and clinical effect and so on. Results Of 21 patients treated with stent-assisted coiling, 15 received the complete occlusion of the aneurysms and 6 the aneurysmal neck residue. The aneurysm intraoperatively ruptured in 1 patient and postoperative intracranial hemorrhage occurred again in 2 patients. All the patients were followed up from 6 to 24 months (mean, 12 months). Of 15 patients were followed up by DSA, 9 receiving complete occlusion of aneurysms had no recurrent aneurysms, 5 with postoperative aneurismal neck residue received the occlusion of aneurismal necks and 1 with postoperative aneurismal neck residue still had aneurysmal neck residue during the following up. There was the stent shift in 2 patients and there was mild stenosis of the parent artery in 1 patient. Conclusions The stent-assisted coil embolization of ACoA aneurysms is of the advantages such as safety, low recurrence rate and good effect. The postoperative complications can be decreased and the clinical effect can be increased by proper selection of embolismic materials.

参考文献/References:

[1] Molyneux A, Kerr R, Stratton I, et al. International sub- arachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized trial [J]. Lancet, 2002, 360(9342): 1267-1274.
[2] Connolly ES Jr, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurismal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Associa- tion [J]. Stroke, 2012, 43(6):1711-1737.
[3] Tsutsumi M, Aikawa H, Onizuka M, et al. Endovascular treatment of tiny ruptured anterior communicating artery aneurysms [J]. Neuroradiology, 2008, 50(6): 509-515.
[4] Gonzalez N, Sedrak M, Martin N, et al. Impact of anatomic features in the endovascular embolization of 181 anterior communicating artery aneurysms [J]. Stroke, 2008, 39(10): 2776-2782.
[5] Gallas S, Pasco A, Cottier JP, et al. A multicenter study of 705 ruptured intracranial aneurysms treated with Guglielmi detachable coils [J]. Am J Neuroradiol, 2005, 26(7): 1723- 1731.
[6] Lubicz B, Lefranc F, Bruneau M, et al. Balloon-assisted coiling of intracranial aneurusms is not associated with a higher complication rate [J]. Neuroradiology, 2008, 50(9): 769-776.
[7] Cekirge HS, Yavuz K, Geyik S, et al. Hyperform balloon remodeling in the endovascular treatment of anterior cere- bral, middle cerebral, and anterior communicating artery aneurysms: clinical and angiographic follow-up-results in 800 consecutive patients [J]. J Neurosurg, 2011, 114(4): 944-953.
[8] Youn SO, Lee JL, Ko JK, et al. Endovascular treatment of wide-necked intracranial aneurysms using balloon-assisted technique with Hyperform balloon [J]. J Korean Neurosurg, 2010, 48(3): 207-212.
[9] 何伟文,伍健伟,李明昌,等. 血管内栓塞治疗宽颈颅内动 脉瘤[J]. 中国脑血管病杂志,2007,4(8):356-359.
[10] Scott RB, Eccles F, Molyneux AJ, et al. Improved cognitive outcomes with endovascular coiling of ruptured intracranial aneurysms: neuropsychological outcomes from the Interna- tional Subarachnoid Aneurysm Trial (ISAT)[J]. Stroke, 2010, 41(8): 1743-1747.
[11] Chan A, Ho S, Poon WS. Neuropsychological sequelae of patients treated with microsurgical clipping or endovascular embolization for anterior communicating artery aneurysm [J]. Eur Neurol, 2002, 47(1): 37-44.
[12] Hong B, Yang PF, Zhao R, et al. Endovascular treatment of ruptured tiny intracranial aneurysms [J]. J Clin Neurosci, 2011, 18(5): 655-660.
[13] 梁建峰,伍健伟,何伟文. 支架辅助血管内栓塞治疗前交 通宽颈动脉瘤[J]. 广东医学,2013,34(19):2959-2961.
[14] 陆 川,陈献东,蔡建勇,等. 血管内栓塞破裂性前交通动 脉瘤术前影像学评估[J]. 中国脑血管病杂志(电子版), 2011,5(3):205-209.

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更新日期/Last Update: 2016-02-25