[1]智通乐,孟成杰,杨威.椎-基底动脉夹层动脉瘤破裂急性期应用双LVIS支架重叠技术辅助弹簧圈栓塞治疗的疗效[J].中国临床神经外科杂志,2024,29(09):518-521.[doi:10.13798/j.issn.1009-153X.2024.09.002]
　ZHI Tong-le,MENG Cheng-jie,YANG Wei.Efficacy of dual LVIS stent overlap technique-assisted coil embolization for ruptured vertebrobasilar artery dissecting aneurysms in the acute stage[J].,2024,29(09):518-521.[doi:10.13798/j.issn.1009-153X.2024.09.002]
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椎-基底动脉夹层动脉瘤破裂急性期应用双LVIS支架重叠技术辅助弹簧圈栓塞治疗的疗效()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年09期
页码:
518-521
栏目:
论著
出版日期:
2024-09-30

文章信息/Info

Title:
Efficacy of dual LVIS stent overlap technique-assisted coil embolization for ruptured vertebrobasilar artery dissecting aneurysms in the acute stage
文章编号:
1009-153X（2024）09-0518-04
作者:
智通乐; 孟成杰; 杨威
224001 江苏盐城，南京大学医学院附属盐城第一医院神经外科（智通乐、孟成杰），血管外科（杨　威）
Author(s):
ZHI Tong-le1;  MENG Cheng-jie1;  YANG Wei2
1. Department of Neurosurgery, Yancheng First Hospital Affiliated to Nanjing University School of Medicine, Yancheng 224001, China; 2. Department of Vascular Surgery, Yancheng First Hospital Affiliated to Nanjing University School of Medicine, Yancheng 224001, China
关键词:
颅内夹层动脉瘤; 颅内破裂动脉瘤; 椎-基底动脉; 血管内治疗; 双LVIS支架重叠技术; 疗效
Keywords:
Intracranial dissecting aneurysm;  Ruptured intracranial aneurysm;  Vertebrobasilar artery;  Endovascular therapy;  Double LVIS stent overlap technique;  Efficacy
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2024.09.002
文献标志码:
A
摘要:
目的 探讨椎-基底动脉夹层动脉瘤破裂急性期应用双LVIS支架重叠技术辅助弹簧圈栓塞治疗的疗效。方法 回顾性分析2019年10月至2022年9月应用双LVIS支架重叠技术辅助弹簧圈栓塞治疗的13例椎-基底动脉夹层动脉瘤的临床资料。结果 入院时Hunt-Hess分级Ⅰ级5例，Ⅱ级4例，Ⅲ级3例，Ⅳ级1例。动脉瘤位于基底动脉1例、椎动脉动12例[小脑后下动脉（PICA）远端6例、近端4例，累及PICA有2例]。发病至入院时间2~18 h，平均（7.20±1.55）h。术后即刻造影显示Raymond分级Ⅰ级9例，Ⅱ级4例。围手术期出现并发症4例（30.77%），其中3例（23.08%）术后24 h内发生缺血并发症，1例因动脉瘤再破裂出血死亡。出院时改良Rankin量表（mRS）评分1分4例，2分3例，3分3例，4分2例；术后6个月随访mRS评分0分6例，1分5例，2分1例。12例术后6个月造影随访未见动脉瘤显影，载瘤动脉通畅。结论 椎-基底动脉夹层动脉瘤破裂急性期，应用双LVIS支架重叠技术辅助弹簧圈栓塞治疗，安全性高，可有效改善病人的预后。
Abstract:
Objective To explore the efficacy of dual LVIS stent overlap technique-assisted coil embolization for ruptured vertebrobasilar artery dissecting aneurysms in the acute stage. Methods The clinical data of 13 patients with ruptured vertebrobasilar artery dissecting aneurysms treated with dual LVIS stent overlap technique-assisted coil embolization from October 2019 to September 2022 were retrospectively analyzed. Results On admission, there were 5 cases of Hunt-Hess grade Ⅰ, 4 cases of grade Ⅱ, 3 cases of grade Ⅲ, and 1 case of grade Ⅳ. The aneurysms were located in the basilar artery in 1 case and the vertebral artery in 12 cases [6 cases at the distal posterior inferior cerebellar artery (PICA), 4 cases at the proximal PICA, and 2 cases involving the PICA]. The time from onset to admission was 2~18 hours, with an average of (7.20±1.55) hours. Immediate postoperative angiography showed Raymond grade Ⅰ in 9 cases and grade Ⅱ in 4 cases. Perioperative complications occurred in 4 cases (30.77%), of whom 3 cases (23.08%) had ischemic complications within 24 hours after surgery, and 1 case died due to re-rupture and hemorrhage of the aneurysm. At discharge, the modified Rankin Scale (mRS) score was 1 in 4 cases, 2 in 3 cases, 3 in 3 cases, and 4 in 2 cases; at 6-month follow-up after surgery, the mRS score was 0 in 6 cases, 1 in 5 cases, and 2 in 1 case. Angiography follow-up at 6 months after surgery showed no aneurysm in 12 cases, and the parent arteries were patent. Conclusion In the acute stage of ruptured vertebrobasilar artery dissecting aneurysms, dual LVIS stent overlap technique-assisted coil embolization has high safety and can effectively improve the prognosis of patients.

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备注/Memo

备注/Memo:
（2023-10-13收稿，2024-03-21修回）
基金项目：江苏省“六大人才高峰”高层次人才选拔培养资助项目（WSW-006）；盐城市科技项目（YK2013020）；苏州市科教兴卫临床诊疗技术专项资助项目（LCZX201601）
通信作者：孟成杰，Email：ji5520h@163.com
更新日期/Last Update: 2024-09-30