摘要
目的初步探讨Neuroform Atlas支架辅助弹簧圈治疗颅内宽颈动脉瘤的疗效及安全性。方法回顾性分析2020年8—12月郑州大学人民医院神经外科应用Neuroform Atlas支架辅助弹簧圈栓塞治疗的64例颅内宽颈动脉瘤患者(67个动脉瘤)的临床资料。其中10例患者(12个动脉瘤)同时采用尾端套叠式"Y"型支架技术治疗。术后3个月进行临床随访,采用改良Rankin量表评分(mRS)评估患者的临床预后。术后5~6个月复查数字减影血管造影(DSA),采用Raymond分级评估动脉瘤的闭塞情况。结果67个动脉瘤置入的74枚Neuroform Atlas支架均成功释放,术中发生操作相关并发症1例。67个动脉瘤的术后即刻DSA显示,56个(83.6%)动脉瘤完全闭塞(RaymondⅠ级),4个(6.0%)动脉瘤瘤颈残留(RaymondⅡ级),7个(10.4%)动脉瘤瘤体残留(RaymondⅢ级)。术后1例患者因脑疝死亡,2例发生脑梗死。术后失访3例,60例患者完成3个月随访,其中mRS 0分53例,1分4例,2分2例,3分1例。术后5~6个月,53例患者(55个动脉瘤)完成影像学随访,其中动脉瘤闭塞达RaymondⅠ级50个(90.9%),Ⅱ级2个(3.6%),Ⅲ级3个(5.5%),且均未发现支架内狭窄或迟发性血栓事件。结论初步发现,Neuroform Atlas支架辅助弹簧圈治疗颅内宽颈动脉瘤具有较高的闭塞率和较低的并发症发生率,有效性及安全性均较好。
Objective To preliminarily explore the efficacy and safety of Neuroform Atlas stent-assisted coiling in the treatment of intracranial wide-necked aneurysms.Methods A retrospective analysis was conducted on the clinical data of 64 patients harboring 67 intracranial wide-necked aneurysms treated with Neuroform Atlas stent-assisted coiling at the Department of Neurosurgery,Zhengzhou University People′s Hospital from August to December 2020.Ten patients(12 aneurysms)were treated with the overlap"Y"stent technique.The clinical follow-up was performed 3 months after the operation,and the clinical outcome of the patients was evaluated based on the modified Rankin scale(mRS).Digital subtraction angiography(DSA)was reviewed at 5 to 6 months post operation and Raymond grading scale was used to assess the occlusion status of aneurysm.Results A total of 74 Neuroform Atlas stents were successfully implanted in 67 aneurysms and there was 1 case of intraoperative complication.Immediate post-procedural DSA of 67 aneurysms showed that 56(83.6%)aneurysms were completely occluded(RaymondⅠ),4(6.0%)had residual aneurysmal necks(RaymondⅡ),and 7(10.4%)had residual aneurysmal domes(RaymondⅢ).After the operation,1 patient died of cerebral herniation and 2 patients had cerebral infarction.Three patients were lost to follow-up and 60 patients completed a 3-month follow-up.The mRS was 0 in 53 patients,1 in 4,2 in 2 and 3 in 1.Fifty-three patients(55 aneurysms)underwent imaging follow-up at 5-6 months post procedure,among whom 50(90.9%)reported complete occlusion(RaymondⅠ),2(3.6%)had residual aneurysmal neck(RaymondⅡ),and 3(5.5%)had residual aneurysmal dome(RaymondⅢ),and there was no in-stent stenosis or delayed thrombosis.Conclusions The preliminary observation suggests that Neuroform Atlas stent-assisted coiling has high occlusion rate and low complication rate in the treatment of intracranial wide necked aneurysms.It seems effective and safe.
作者
邵秋季
李立
李天晓
常凯涛
朱良付
薛绛宇
王子亮
张广林
张倩倩
吴桥伟
Shao Qiuji;Li Li;Li Tianxiao;Chang Kaitao;Zhu Liangfu;Xue Jiangyu;Wang Ziliang;Zhang Guanglin;Zhang Qianqian;Wu Qiaowei(Department of Neurosurgery,Zhengzhou University People′s Hospital(Henan Provincial People′s Hospital),Henan University People′s Hospital,Zhengzhou 450003,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2022年第1期59-64,共6页
Chinese Journal of Neurosurgery
基金
河南省医学科技攻关计划联合共建项目(LHGJ 20200058,LHGJ 20190601)。
作者简介
通信作者:李天晓,Email:dr.litianxiao@vip.163.com。
