摘要
目的初步探讨应用Neuroform Atlas支架辅助弹簧圈治疗破裂前交通动脉宽颈动脉瘤的有效性和安全性。方法回顾性分析2020年8月至2021年4月河北医科大学附属唐山工人医院神经外科收治的14例破裂前交通动脉宽颈动脉瘤患者的临床资料。14例患者术前行数字减影血管造影(DSA)检查确诊,共14个前交通动脉宽颈动脉瘤。所有患者均接受Neuroform Atlas支架辅助弹簧圈栓塞治疗,其中9例患者选择双导管系统,5例选择单导管系统。术后即刻行DSA检查,采用Raymond分级评估动脉瘤栓塞情况。观察术后并发症情况,以评估治疗的安全性。术后6个月随访患者,复查DSA,评估动脉瘤有无复发及支架内血流通畅情况。结果14例患者的Neuroform Atlas支架均成功释放,术中支架到位满意;术中均未出现载瘤动脉痉挛、动脉瘤破裂出血、支架打开不良、支架内血栓形成等手术相关的并发症。术后即刻DSA显示,14例动脉瘤均为完全栓塞(RaymondⅠ级)。术后无一例患者出现短暂性脑缺血发作、脑梗死或脑出血,无死亡病例。14例患者中,8例完成术后6个月随访。8例患者的DSA结果均显示动脉瘤完全栓塞(RaymondⅠ级),瘤颈处未出现弹簧圈压缩,未见动脉瘤复发,支架内血流通畅、无狭窄或血栓形成。结论初步研究发现,应用Neuroform Atlas支架辅助弹簧圈栓塞破裂前交通动脉宽颈动脉瘤是有效和安全的。
Objective To preliminarily investigate the safety and effectiveness of Neuroform Atlas stent-assisted coil embolization of ruptured anterior communicating wide-necked aneurysms.Methods A retrospective analysis was conducted on the clinical data of 14 patients with ruptured anterior communicating wide-necked aneurysms admitted to the Department of Neurosurgery,Tangshan Gongren Hospital of Hebei Medical University from August 2020 to April 2021.All 14 patients underwent preoperative digital subtraction angiography(DSA)to confirm the diagnosis.There were a total of 14 anterior communicating artery wide-necked aneurysms.All patients underwent Neuroform Atlas stent-assisted coil embolization treatment.Among them,the dual catheter system was used in 9 patients and the single catheter system in 5.DSA was performed immediately after the operation,and the Raymond grade was used to assess the embolization of the aneurysm.We observed postoperative complications to assess the safety of treatment.The patients were followed up for 6 months after the operation,and DSA was reviewed to assess whether the aneurysm had recurrence and the stent patency.Results The Neuroform Atlas stents of 14 patients were successfully released and the stents were in place satisfactorily during the operation.There were no surgery-related complications such as spasm of the tumor-bearing artery,rupture of aneurysm and hemorrhage,poor stent expansion,and thrombosis in the stent.Immediately after the operation,DSA showed that all 14 aneurysms were completely embolized(RaymondⅠ).There was no transient ischemic attack,cerebral infarction or cerebral hemorrhage in any patient after the operation,and no death cases.Of the 14 patients,8 completed the 6-month follow-up.The DSA results of 8 patients showed complete embolization of the aneurysm(RaymondⅠ),no coil compression at the neck of the aneurysm,no recurrence of the aneurysm,good stent patency,no stenosis or thrombosis.Conclusion This preliminary study has suggested that the application of Neuroform Atlas stent-assisted coil embolization of ruptured wide-necked aneurysms of the anterior communicating artery seems effective and safe.
作者
王红平
徐翔
王大永
裴剑
郑宇
田宝刚
高云鹤
Wang Hongping;Xu Xiang;Wang Dayong;Pei Jian;Zheng Yu;Tian Baogang;Gao Yunhe(Department of Neurosurgery,Tangshan Gongren Hospital of Hebei Medical University,Tangshan 063000,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2021年第8期810-814,共5页
Chinese Journal of Neurosurgery
作者简介
通信作者:徐翔,Email:xuxiang88899@sina.com。
