[1]李孟凯,张义森,王坤,等.LVIS支架辅助栓塞颅内大型动脉瘤的疗效[J].中国临床神经外科杂志,2023,28(08):500-503532.[doi:10.13798/j.issn.1009-153X.2023.08.007]
　LI Meng-kai,ZHANG Yi-sen,WANG Kun,et al.Efficacy and safety of stent-assisted coiling of large intracranial aneurysms using the low-profile visualized intraluminal support (LVIS) device[J].,2023,28(08):500-503532.[doi:10.13798/j.issn.1009-153X.2023.08.007]
点击复制

LVIS支架辅助栓塞颅内大型动脉瘤的疗效()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年08期
页码:
500-503532
栏目:
论著
出版日期:
2023-08-31

文章信息/Info

Title:
Efficacy and safety of stent-assisted coiling of large intracranial aneurysms using the low-profile visualized intraluminal support (LVIS) device
文章编号:
1009-153X（2023）08-0500-04
作者:
李孟凯; 张义森; 王坤; 张莹; 李文强; 田忠彬; 刘健
044000山西，运城市中心医院神经外一科（李孟凯）；100070北京，首都医科大学附属北京天坛医院神经外科中心（张义森、王坤、张莹、刘健）；450052郑州，郑州大学第一附属医院神经外科（李文强）；510280广州，南方医科大学珠江医院脑血管病外科（田忠彬）
Author(s):
LI Meng-kai1;  ZHANG Yi-sen2;  WANG Kun2;  ZHANG Ying2;  LI Wen-qiang3;  TIAN Zhong-bin4;  LIU Jian2
1. Department of Neurosurgery, Yuncheng Central Hospital, Yuncheng 044000, China; 2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China; 3. Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; 4. Department of Cerebrovascular Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, China
关键词:
颅内大型动脉瘤; LVIS支架; 血管内治疗; 疗效
Keywords:
Large intracranial aneurysm;  LVIS stent;  Endovascular treatment;  Efficacy
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2023.08.007
文献标志码:
R 743.9; R 815.2
摘要:
目的 探讨LVIS支架辅助弹簧圈栓塞颅内大型动脉瘤的有效性和安全性。方法 回顾性分析2014年10月至2017年5月采用LVIS支架辅助栓塞治疗的24例颅内大型动脉瘤的临床资料。结果 24例均为单发动脉瘤，动脉瘤最大径10.1~20.2 mm，平均为13.7 mm。24个动脉瘤均使用一枚LVIS支架，所有支架都成功打开并顺利完成动脉瘤填塞；术后即刻造影显示Raymond分级Ⅰ级14例，Ⅱ级9例，Ⅲ级1例。3例围手术期出现并发症，包括1例颈内动脉交通段破裂动脉瘤发生术中破裂，1例左侧颈内动脉眼动脉段动脉瘤术后1 h发生支架内血栓形成，1例右侧颈内动脉眼动脉段动脉瘤栓塞术后出现同侧视力障碍。21例（87.5%）进行3.9~36.8个月的临床随访，平均（10.85±8.6）个月，20例mRS评分0分，1例mRS评分1分。18例（75.0%）获得平均9.94个月血管影像学随访，5例动脉瘤出现复发，11例动脉瘤无明显变化，2例动脉瘤进一步愈合。结论 LVIS支架辅助栓塞是治疗颅内大型动脉瘤的安全的、可行的方法。
Abstract:
Objective To investigate the efficacy and safety of LVIS stent-assisted coil embolization for patients with large intracranial aneurysms. Methods The clinical data of 24 patients with large intracranial aneurysms treated with LVIS stent assisted embolization from October 2014 to May 2017 were retrospectively analyzed. Results The maximum diameter of aneurysms was 10.1~20.2 mm (mean, 13.7 mm). All the 24 patients had single aneurysms and were treated with a LVIS stent, all of which were successfully opened and tamped. Immediate postoperative angiography showed Raymond grade Ⅰ in 14 patients, grade Ⅱ in 9 patients, and grade Ⅲ in 1 patient. Perioperative complications occurred in 3 patients, including intraoperative rupture in 1 patient with communicating segment aneurysm of the internal carotid artery in 1 patient, intra-stent thrombosis in 1 patient with left internal carotid ophthalmic segment aneurysm, and ipilateral visual impairment in 1 patient with right internal carotid ophthalmic segment aneurysm. Twenty-one patients (87.5%) were followed up for 3.9~36.8 months in clinic, with an average of (10.85±8.6) months; a mRS score of 0 was achieved in 20 patients, and a mRS score of 1 in 1. Eighteen patients (75%) were followed up for an average of 9.94 months by angiographic imaging; 5 patients had aneurysm recurrence, 11 patients had no significant aneurysm change, and 2 patients had aneurysm further healing. Conclusions LVIS stent assisted embolization is a safe and feasible method for the treatment of large intracranial aneurysms.

参考文献/References:

[1]LECLER A, RAYMOND J, RODRIGUEZ-REGENT C, et al. Intracranial aneurysms: recurrences more than 10 years after endovascular treatment-a prospective cohort study, systematic review, and meta-analysis [J]. Radiology, 2015, 277: 173-180.
[2]CHALOUHI N, JABBOUR P, SINGHAL S, et al. Stentassisted coiling of intracranial aneurysms: predictors of complications, recanalization, and outcome in 508 cases [J]. Stroke, 2013, 44: 1348-1353.
[3]FENG Z, FANG Y, XU Y, et al. The safety and efficacy of low profile visualized intraluminal support (LVIS) stents in assisting coil embolization of intracranial saccular aneurysms: a single center experience [J]. J Neurointerv Surg, 2016, 8: 1192-1196.
[4]张振海，沈春森，吴中学，等. 颅内巨大动脉瘤的血管内治疗分析[J]. 中国临床神经外科杂志，2015，20：469-472.
[5]ATALLAH E, SAAD H, MOUCHTOURIS N, et al. Pipeline for distal cerebral circulation aneurysms [J]. Neurosurgery, 2019, 85(3): E477-E484.
[6]DMYTRIW AA, PHAN K, SALEM MM, et al. The pipeline embolization device: changes in practice and reduction of complications in the treatment of anterior circulation aneurysms in a multicenter cohort [J]. Neurosurgery, 2020, 86(2): 266-271.
[7]BHATIA KD, KORTMAN H, ORRU E, et al. Periprocedural complications of second-generation flow diverter treatment using Pipeline Flex for unruptured intracranial aneurysms: a systematic review and meta-analysis [J]. J Neurointerv Surg, 2019, 11(8): 817-824.
[8]中国医师协会神经介入专业委员会出血性脑血管病神经介入专业委员会（学组），中国医师协会神经外科医师分会神经介入专业委员会，中国医师协会介入医师分会神经介入专业委员会. 血流导向装置治疗颅内动脉瘤的中国专家共识[J]. 中华神经外科杂志，2020，36（5）：433-445.
[9]KULCSAR Z, HOUDART E, BONAFE A, et al. Intra-aneurysmal thrombosis as a possible cause of delayed aneurysm rupture after flow-diversion treatment [J]. AJNR Am J Neuroradiol, 2011, 32: 20-25.
[10]尤　为，刘　鹏，李佑祥. Pipeline血流导向装置治疗颅内动脉瘤出血性并发症的研究进展[J]. 中华神经外科杂志，2019，35（12）：1277-1281.
[11]WANG C, WU Y, FENG Z, et al. Preliminary experience with the use of low profile visualized intraluminal support device in basilar artery for aneurysm treatment [J]. J Neurointerv Surg, 2019, 11: 405-410.
[12]FIORELLA D, BOULOS A, TURK AS, et al. The safety and effectiveness of the LVIS stent system for the treatment of widenecked cerebral aneurysms: final results of the pivotal US LVIS trial [J]. J Neurointerv Surg, 2019, 11: 357-361.
[13]SU W, ZHANG Y, CHEN J, et al. 225 intracranial aneurysms treated with the low-profile visualized intraluminal support (LVIS) stent: a single-center retrospective study [J]. Neurol Res, 2018, 40: 445-451.
[14]WANG C, TIAN Z, LIU J, et al. Flow diverter effect of LVIS stent on cerebral aneurysm hemodynamics: a comparison with Enterprise stents and the Pipeline device [J]. J Transl Med, 2016,14(1): 199.
[15]LI W, WANG Y, ZHANG Y, et al. Efficacy of LVIS vs. Enterprise stent for endovascular treatment of mediumsized intracranial aneurysms: a hemodynamic comparison study [J]. Front Neurol, 2019, 10: 522.
[16]WANG J, VARGAS J, SPIOTTA A, et al. Stent-assisted coiling of cerebral aneurysms: a single-center clinical and angiographic analysis [J]. J Neurointerv Surg, 2018, 10: 687-692.
[17]FENG X, QIAN Z, LIU P, et al. Comparison of recanalization and in-stent stenosis between the low-profile visualized intraluminal support stent and enterprise stent-assisted coiling for 254 intracranial aneurysms [J]. World Neurosurg, 2018, 109: E99-E104.
[18]YAN P, ZHANG YP, LIANG F, et al. Comparison of safety and effectiveness of endovascular treatments for unruptured intracranial large or giant aneurysms in internal carotid artery [J]. World Neurosurg, 2019, 125: E385-E391.
[19]OISHI H, TERANISHI K, YATOMI K, et al. Flow diverter therapy using a Pipeline embolization device for 100 unruptured large and giant internal carotid artery aneurysms in a single center in a Japanese population [J]. Neurol Med Chir (Tokyo), 2018, 58(11): 461-467.
[20]ENRIQUEZ-MARULANDA A, SALEM MM, ASCANIO LC, et al. No differences in effectiveness and safety between pipeline embolization device and stent-assisted coiling for the treatment of communicating segment internal carotid artery aneurysms [J]. Neuroradiol J, 2019, 32(5): 344-352.

相似文献/References:

[1]罗　明　闵　强　黄乔春　段发亮.Lvis支架在颅内宽颈动脉瘤栓塞中的应用[J].中国临床神经外科杂志,2016,(08):458.[doi:10.13798/j.issn.1009-153X.2016.08.004]
　LUO Ming,MIN Qiang,HUANG Qiao-chun,et al.Application of Lvis stent to endovascular treatment of intracranial wide-neck aneurysms[J].,2016,(08):458.[doi:10.13798/j.issn.1009-153X.2016.08.004]
[2]胡　骁　周林裕　殷汉荣　杨艳如　代永庆.Lvis支架辅助弹簧圈栓塞破裂宽颈前交通动脉动脉瘤的疗效分析[J].中国临床神经外科杂志,2017,(05):325.[doi:10.13798/j.issn.1009-153X.2017.05.014]
[3]梁甲宁　张　广　刘彬冰　任　森　史怀璋.颅内动脉瘤LVIS支架辅助栓塞后中长期随访分析[J].中国临床神经外科杂志,2018,(03):152.[doi:10.13798/j.issn.1009-153X.2018.03.004]
　LIANG Jia-ning,ZHANG Guang,LIU Bin-bing,et al.Effects and safety of LVIS stent-assisted embolization of intracranial aneurysms: a long-term follow-up study[J].,2018,(08):152.[doi:10.13798/j.issn.1009-153X.2018.03.004]
[4]明智绪　万　定　李东蛟　朱辰路　杨振兴　冯　进　李曦男　李宗正.LVIS支架在颅内动脉瘤血管内栓塞治疗中的应用[J].中国临床神经外科杂志,2018,(06):398.[doi:10.13798/j.issn.1009-153X.2018.06.005]
　MING Zhi-xu,WAN Ding,LI Dong-jiao,et al.Application of LVIS stent in endovascular embolization of intracranial aneurysms[J].,2018,(08):398.[doi:10.13798/j.issn.1009-153X.2018.06.005]
[5]韦成聪、谢昌纪、周志宇、陈杰飞.LVIS支架辅助栓塞治疗颅内后循环动脉瘤的疗效[J].中国临床神经外科杂志,2019,(07):406.[doi:10.13798/j.issn.1009-153X.2019.07.008]
　WEI Cheng-cong,XIE Chang-ji,ZHOU Zhi-yu,et al.Clinical effects of LVIS devices-assisted endovascular treatment on posterior circulation intracranial aneurysms[J].,2019,(08):406.[doi:10.13798/j.issn.1009-153X.2019.07.008]
[6]武　文　林　强　车树圣　闫志勇.LVIS支架在颅内微小动脉瘤治疗中的应用[J].中国临床神经外科杂志,2019,(11):690.[doi:10.13798/j.issn.1009-153X.2019.11.017]
[7]明智绪　冯　进　黄德俊　万　定　朱辰路　杨振兴　李曦男　李宗正.双LVIS支架辅助治疗颈内动脉微小宽颈破裂动脉瘤1例[J].中国临床神经外科杂志,2020,(02):127.[doi:10.13798/j.issn.1009-153X.2020.02.023]
[8]李欢欢　李　俊　盛柳青　陈迎春　别毕洲　汪志忠　游慧超　叶建锋.LVIS支架辅助栓塞颈内动脉床突上段破裂夹层动脉瘤[J].中国临床神经外科杂志,2020,(07):430.[doi:10.13798/j.issn.1009-153X.2020.07.005]
　LI Huan-huan,LI Jun,SHENG Liu-qing,et al.LVIS stent assisted coils embolization for ruptured dissecting aneurysms in the internal carotid artery supraclinoid segment[J].,2020,(08):430.[doi:10.13798/j.issn.1009-153X.2020.07.005]
[9]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.[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,(08):737.[doi:doi:10.13798/j.issn.1009-153X.2020.11.001]
[10]邵东传,吴钧,高云,等.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[J].中国临床神经外科杂志,2022,27(08):629.[doi:10.13798/j.issn.1009-153X.2022.08.002]
　SHAO Dong-chuan,WU Jun,GAO Yun,et al.Efficacy and safety of LVIS stent-assisted coil embolization for dissecting aneurysms of the supraclinoid internal carotid artery[J].,2022,27(08):629.[doi:10.13798/j.issn.1009-153X.2022.08.002]

备注/Memo

备注/Memo:
（2023-02-22收稿，2023-07-17修回）
基金项目：北京市属医院科研培育计划（PX2022022）
通讯作者：刘　健，E-mail：jianliu_ns@163.com
更新日期/Last Update: 2022-08-31