摘要
目的探讨支架和球囊辅助技术在颅内宽颈动脉瘤栓塞治疗的应用体会。方法采用支架和球囊辅助瘤颈成形术对87例患者92个颅内宽颈动脉瘤进行栓塞治疗。支架辅助技术为首先选择合适的 Neuroform 支架跨动脉瘤颈释放,长度超出瘤颈近、远端各5 mm,微导管通过支架上的网孔进入动脉瘤,一期或分期完成电解可脱性弹簧圈(GDC)栓塞。球囊辅助技术采用双导管,微导管送入动脉瘤内后,不可脱球囊置于瘤颈,充盈以覆盖瘤颈,再行 GDC 填塞动脉瘤。结果支架辅助栓塞完全填塞的动脉瘤31个,次全填塞(>90%)3个,大部填塞(70%～90%)1个,载瘤动脉均保持通畅,无死亡,轻度神经功能障碍3例;球囊辅助栓塞完全填塞50个,次全填塞4个,无死亡,轻度神经功能障碍1例;同时采用支架和球囊辅助栓塞完全填塞的动脉瘤2个,次全填塞1个,无死亡。平均随访5.8个月,其中支架辅助栓塞再通率16.7%,球囊辅助栓塞再通率12.5%。结论支架及球囊辅助技术是处理颅内宽颈动脉瘤安全、有效的方法。采用球囊保护栓塞技术较支架辅助技术具有更大的安全性。
Objective To discuss the avail of balloon and stcnt-assisted Gugliehni detachable coil （GDC） placement in treatment of wide-necked cerebral aneurysm. Methods Eighty-seven patients with 92 wide-necked aneurysms undergone endovascular procedures using the balloon and stent-assisted remodeling technique. Respectively, appropriate Neuroform stents delivered with a 5 mm landing zone on either side of the aneurysm neck, the microcatheter entered through the interstice, aneurysms were embolized at one or several times. Two catheters were used in balloon-remodeling technique, balloon were inflated across the neck of the aneurysms after the microcatheter entering the aneurysms, then the GDC were used to embolize the aneurysms. Results Thirty-one aneurysms were completely occluded, 3 subtotally （ 〉 90% ） and 1 incompletely （70% - 90% ） occluded using stent-assisted technique, all carry arteries were unblocked, 3 patients with mild neurological dysfunction and no mortality. Fifty aneurysms were completely occluded and 4 incompletely occluded using balloon-assisted technique, 1 patients with mild neurological dysfunction and no mortality. Two aneurysms were completely occluded and 1 incompletely occluded using stem-assisted and balloon-assisted technique. The meem period of follow-up was 5.8 months. Rates of recanalization were 16. 7% for stent-remodeling group and 12. 5% for balloon-remodehng group. Condusions The stent and balloon-assisted remodeling technique are safe and effective in treating wide-necked aneurysms. Balloonremodeling technique has more security comparing with stents.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2007年第4期220-222,共3页
Chinese Journal of Surgery
关键词
动脉瘤
支架
球囊
弹簧圈
Aneurysm
Stents
Balloon
Gugliehni detachable coil
