[1]潘 力 刘 鹏 秦 杰 杨 柳 安学峰 吴 虓 杨 铭 徐国政 马廉亭.Y型支架辅助技术在颅内动脉分叉部宽颈动脉瘤治疗中的应用[J].中国临床神经外科杂志,2016,(07):394-397.[doi:10.13798/j.issn.1009-153X.2016.07.002]
 PAN Li,LIU Peng,QIN Jie,et al.Application of Y -configuration stent technique to treatment of intracranial wide-neck bifurcation aneurysms[J].,2016,(07):394-397.[doi:10.13798/j.issn.1009-153X.2016.07.002]
点击复制

Y型支架辅助技术在颅内动脉分叉部宽颈动脉瘤治疗中的应用()
分享到:

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

卷:
期数:
2016年07期
页码:
394-397
栏目:
论著
出版日期:
2016-07-15

文章信息/Info

Title:
Application of Y -configuration stent technique to treatment of intracranial wide-neck bifurcation aneurysms
文章编号:
1009-153X(2016)07-0394-04
作者:
潘 力 刘 鹏 秦 杰 杨 柳 安学峰 吴 虓 杨 铭 徐国政 马廉亭
430070 武汉,广州军区武汉总医院神经外科(潘 力、刘鹏、秦 杰、杨 柳、安学峰、吴 虓、杨 铭、徐国政、马廉亭)
Author(s):
PAN Li LIU Peng QIN Jie YANG Liu AN Xue-feng WU Xiao YANG Ming XU Guo-zheng MA Lian-ting
Department of Neurosurgery, Wuhan General Hospital, Guangzhou Command, PLA, Wuhan 430070, China
关键词:
颅内动脉瘤宽颈动脉瘤血管分叉部血管内治疗Y型支架技术
Keywords:
Intracranial wide-neck aneurysms Endovascular therapy Y-stent Coils Curative effect
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2016.07.002
文献标志码:
A
摘要:
目的 探讨Y型支架辅助弹簧圈栓塞颅内动脉分叉部宽颈动脉瘤的疗效。方法 回顾性分析2012年10月至2015年10月采用Y型支架辅助弹簧圈栓塞的16例颅内动脉分叉部宽颈动脉瘤的临床资料,均采用闭环Enterprise支架,其中采取并行Y型支架技术9例,交叉Y型支架技术7例。结果 均成功采用Y型支架辅助弹簧圈技术完成动脉瘤的栓塞,技术成功率为100%;1例术前Hunt-Hess分级4级的基底动脉分叉部宽颈动脉瘤因严重脑血管痉挛于术后第二天死亡;1例术后出现一过性神经功能缺失,6个月复查造影见分叉部一分支主干闭塞;1例基底动脉末端大动脉瘤瘤体有复发;余13例经CTA或DSA随访1个月~3年均无再出血及动脉瘤复发。结论 Y型支架辅助技术是治疗颅内动脉分叉部绝对宽颈动脉瘤的有效方法,近期动脉瘤瘤体及瘤颈均达到致密填塞,远期疗效还需进一步观察。
Abstract:
Objective To investigate the clinical characters of intracranial wide-neck bifurcation aneurysms and evaluate the safety and clinical outcomes of treatment with Y-stent-assisted coils. Methods The clinical data of 16 patients with intracranial wide-neck bifurcation aneurysms treated by Y-stent-assisted coils from October, 2012 to October, 2015 was analyzed retrospectively. Results Of 16 consecutive patients undergoing successful Y-stent assisted coiling, 9 were treated by kissing Y-stent technique and 7 by crossing Y-stent technique. The aneurysms were completely occluded in all the patients (100%). One patent with Hunt-Hess grade 4 died from severe cerebral vasospasm 2 days after the operation. The mild neurological deficit occurred after the operation in 1 patient, in whom the occlusion of one main branch of bifurcation was observed by DSA 6 months after the operation. DSA showed that a large basilar apex bifurcation aneurysm recanalized 6 months after the operation. No rebleeding and recanalization of the aneurysms occurred in 13 patients who were followed up by DSA or CTA from 1 month to 3 years. Conclusions Y-stent-assisted coiling is an effective method to treat the complex intracranial wide-neck bifurcation aneurysms when single stent-assisted coiling is not feasible and sufficient. The long-term effect of Y-stent-assisted coiling on the wide-neck bifurcation aneurysms still should be further observed.

参考文献/References:

[1] Chow MM, Woo HH, Masaryk TJ, et al. A novel endovascu- lar treatment of a wide necked basilar apex aneurysm by using a Y-configuration, double-stent technique [J]. Am J Neuroradial, 2004, 25: 509-512.
[2] Chalouni N, Jabbour P, Gonzalez LF, et al. Safety and effi- cacy of endovascular treatment of basilar tip aneurysms by coiling with and without stent assistance: a review of 235 cases [J]. Neurosurgery, 2012, 71: 785-794.
[3] Perez-Arjona E, Fessler RD. Basilar artery to bilateral posterior cerebral artery ’Y stending’ for endovascular reconstruction of wide-necked basilar apex aneurysms: report of three cases [J]. Neruol Res, 2004, 26: 276-281.
[4] Lee WJ, Cho CS. Y-stenting endovascular treatment for ruptured intracranial aneurysms: a single institution expe- rience in Korea [J]. J Korea Neurosurg Soc, 2012, 52: 187- 192.
[5] Martinez M, Saura P, Saura J, et al. Y stent assisted coil embolization of anterior circulation aneurysms using two solitaire AB devices: a single center experience [J]. Interv Neuroradiol, 2012, 18: 158-163.
[6] Yang P, Liu J, Huang Q, et al. Endovascular treatment of wide-neck middle cerebral artery aneurysms with stents: a review of 16 cases [J]. Am J Neuroradiol, 2010, 31: 940- 946.
[7] Limbucci N, Renieri L, Nappini S, et al. Y-stent assisted coiling of bifurcation aneurysms with Enterprise stent: long- term follow up [J]. J Neurointerv Surg, 2014, 8(2): 158-162.
[8] Cekirge HS, Yavuz K, Geyik S, et al. A novel “Y”stent flow diversion technique for the endovascular treatment of bifur- cation aneurysms without endosaccular coiling [J]. Am J Neuroradiol, 2011, 32: 1262-1268.
[9] Robert SH, Jason PR, Adel MM, et al. Y-stent embolization technique for intracranial bifurcaton aneurysms [J]. J Clin Neurosci, 2014, 14: 1368-1372.
[10] Kenichi K, Aki S , Tomoaki T, et al. Retreatment of recana- lized aneurysms after Y-stent-assisted coil embolization with double Enterprise stents:case report and systematic review of the literature [J]. Turk Neurosurg, 2014, 24: 593- 597.

相似文献/References:

[1]曾 春 张施远 蒋永明.复合手术与常规夹闭术治疗颈内动脉后交通动脉破裂动脉瘤的疗效对比研究[J].中国临床神经外科杂志,2016,(05):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
 ZENG Chun,ZHANG Shi-yuan,JIANG Yong-ming.Analysis of the effects of hybrid surgery on posterior communicating artery aneurysms: a comparison with conventional craniotomy[J].,2016,(07):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
[2]周有东 敖祥生 刘汉东 王志勇 朱耀祖 周达全.支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析[J].中国临床神经外科杂志,2016,(05):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
 ZHOU You-dong,AO Xiang-sheng,LIU Han-dong,et al.A mata-analysis of curative effects of stent-assisted coiling and simple coiling on intracranial aneurysms and their safety[J].,2016,(07):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
[3]赵 平 王雄伟 汪 雷 马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
 ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(07):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
[4]李朝晖 王玉贵 张孟超 综述 赵兴利 审校.CT灌注成像在动脉瘤性蛛网膜下腔出血中的 临床应用进展[J].中国临床神经外科杂志,2016,(05):313.[doi:10.13798/j.issn.1009-153X.2016.05.021]
[5]刘福德 邓剑平 张 涛 陈 虎 李 帅 王俭博 曲友直 赵振伟.椎-基底动脉夹层动脉瘤的血管内治疗(附48例分析)[J].中国临床神经外科杂志,2016,(06):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
 LIU Fu-de,DENG Jian-ping,ZHANG Tao,et al.Endovascular treatment of vertebrobasilar artery dissecting aneurysms (report of 48 cases)[J].,2016,(07):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
[6]吴有志 罗良生 张 健 陈 骅 吴 鸣 刘 振 史 岩.前循环破裂动脉瘤伴脑内血肿的 早期显微手术治疗[J].中国临床神经外科杂志,2016,(06):376.[doi:10.13798/j.issn.1009-153X.2016.06.020]
[7]周 量 刘 丛 张昌伟.早期栓塞术治疗动脉瘤性蛛网膜下腔出血的疗效[J].中国临床神经外科杂志,2016,(07):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
 ZHOU Liang,LIU Cong,ZHANG Chang-wei..Curative effect of early endovascular embolization on patients with ruptured intracranial aneurysms[J].,2016,(07):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
[8]张 莹 荆林凯 张倩倩 刘 健 张义森 王 坤 穆士卿 杨新健.颈内动脉后交通动脉小动脉瘤破裂危险因素分析[J].中国临床神经外科杂志,2016,(03):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
 ZHANG Ying,JING Lin-kai,ZHANG Qian-qian,et al.Analysis of risk factors related to rupture of small (diameter ≤5 mm) posterior communicating artery aneurysms[J].,2016,(07):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
[9]朱作磊 综述 罗良生 审校.动脉瘤性蛛网膜下腔出血的预后相关因素研究进展[J].中国临床神经外科杂志,2016,(03):183.[doi:10.13798/j.issn.1009-153X.2016.03.020]
[10]韩奖励  曹作为.CTA影像模拟眶上锁孔入路手术中颈内动脉的显露[J].中国临床神经外科杂志,2016,(02):87.[doi:10.13798/j.issn.1009-153X.2016.02.009]
 HAN Jiang-li,CAO Zuo-wei..Exposure of the internal carotid artery by surgery via supraorbital keyhole approach simulated on 3D-CTA images[J].,2016,(07):87.[doi:10.13798/j.issn.1009-153X.2016.02.009]
[11]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,(07):458.[doi:10.13798/j.issn.1009-153X.2016.08.004]
[12]王峻,刘仁忠,徐亚青,等.球囊辅助弹簧圈栓塞治疗颅内宽颈动脉瘤28例临床分析[J].中国临床神经外科杂志,2017,(07):499.[doi:10.13798/j.issn.1009-153X.2017.07.019]
[13]田 其 廖建明 韩守孟 秦显尧 杨锐博 许 州 李明昌.微导管辅助栓塞颅内宽颈动脉瘤的疗效分析[J].中国临床神经外科杂志,2020,(06):359.[doi:10.13798/j.issn.1009-153X.2020.06.007]
 TIAN Qi,LIAO Jian-ming,HAN Shou-meng,et al.Microcatheter-assisted embolization for intracranial wide-necked aneurysms (report of 7 cases)[J].,2020,(07):359.[doi:10.13798/j.issn.1009-153X.2020.06.007]

更新日期/Last Update: 1900-01-01