摘要
目的总结应用血流导向装置(FD)治疗小型未破裂颅内动脉瘤的短期疗效和安全性。方法回顾性分析2014年4月至2019年3月郑州大学人民医院神经外科应用FD治疗的110例小型(直径<10 mm)未破裂颅内动脉瘤患者(共145个动脉瘤)的临床资料。其中133个动脉瘤仅采用FD治疗,12个动脉瘤应用FD联合弹簧圈栓塞治疗。采用Raymond分级评估患者的影像学预后,以改良Rankin量表评分(mRS)评估临床预后。结果共使用121枚FD治疗145个动脉瘤,支架置入成功率为99%(120/121)。17枚支架释放后予球囊扩张或导管、导丝按摩后支架张开以及贴壁良好。5例患者(4.5%)发生缺血性并发症。无一例发生出血性并发症。术后6个月行影像学随访50例(共74个动脉瘤),结果显示,RaymondⅠ级栓塞率为67.6%(50/74)。2例发生无症状性支架内狭窄。随访6个月时,mRS 0分101例、1分4例、2分3例、4分1例、5分1例。结论FD治疗小型未破裂颅内动脉瘤的手术成功率高,安全性好。术后6个月临床疗效良好,中长期治疗结果仍需进一步随访。
Objective To summarize the short-term therapeutic effect and safety of flow diverter(FD)in the treatment of small unruptured intracranial aneurysms.Methods From April 2014 to March 2019,clinical data were collected from 110 patients with 145 small(diameter<10 mm)unruptured intracranial aneurysms who were admitted to Department of Neurosurgery,People′s Hospital of Zhengzhou University.Among those,133 aneurysms were treated with FD alone and 12 aneurysms were treated with FD combined with coiling.Radiological outcomes were assessed based on the Raymond grading.Clinical outcomes were assessed based on the modified Rankin scale score(mRS).Results A total of 121 FD were used for 145 aneurysms.The successful rate of stent implantation was 99%(120/121).For 17 FD,balloon dilatation or massage were performed for better cell opening and wall apposition.There were no hemorrhagic complications.Ischemic complications occurred in 5 cases(4.5%).At 6 months post surgery,DSA results showed that Raymond gradeⅠembolism rate was 67.6%(50/74).Asymptomatic stenosis of parent artery was found in 2 cases.The 6-month follow-up results showed the mRS score of 0 in 101 cases,1 in 4 cases,2 in 3 cases,and 4 in 1 case and 5 in 1 case.Conclusions Treatment of small unruptured intracranial aneurysms with FD is associated with high success rate and safety.The 6-month follow-up results seem satisfactory and the long-term treatment results still need further follow-up.
作者
李立
李天晓
邵秋季
朱良付
薛绛宇
王子亮
白卫星
段光明
张广林
Li Li;Li Tianxiao;Shao Qiuji;Zhu Liangfu;Xue Jiangyu;Wang Ziliang;Bai Weixing;Duan Guangming;Zhang Guanglin(Department of Neurosurgery,People′s Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2019年第11期1099-1102,共4页
Chinese Journal of Neurosurgery
基金
十三五国家重点研发计划(2016YFC1300702)
河南省科技攻关项目(182102310658)。
作者简介
通信作者:李天晓,Email:dr.litianxiao@vip.163.com。
