摘要
目的初步分析Lattice血流导向装置(LFD)治疗颅内动脉瘤的安全性和有效性。方法回顾性分析2023年1月至2024年5月于南京医科大学附属泰州人民医院介入科采用LFD治疗的17例(30个动脉瘤)颅内动脉瘤患者的临床及影像学资料。术后6个月行影像学随访,根据O′Kelly-Marotta(OKM)分级评估动脉瘤的闭塞情况。结果17例患者的30个动脉瘤共置入17枚LFD,所有动脉瘤均被LFD完全覆盖。其中15例单纯置入LFD,2例采用LFD联合弹簧圈栓塞;支架均释放成功,均未出现器械缺陷相关事件。17枚LFD中,2枚术中发生贴壁不良,其中1枚LFD末端出现充盈缺损,予以对症处理后好转;术后无一例患者发生手术相关的脑缺血或脑出血事件。术后6个月行影像学随访的11例患者的17个动脉瘤中,15个动脉瘤达到愈合,OKM分级为D级;1个动脉瘤明显缩小,OKM分级为B级(术后1年CT血管造影显示动脉瘤消失);1个颈内动脉夹层动脉瘤较术前无明显变化,OKM分级为A级。1例患者术后6个月随访发现支架远端局部管腔重度狭窄,患者尚无明显的脑缺血表现。结论初步观察显示,LFD治疗颅内动脉瘤,手术的安全性较高、疗效良好。
Objective To preliminarily analyze the safety and efficacy of the Lattice flow diverter(LFD)in the treatment of intracranial aneurysms.Methods A retrospective analysis was conducted on the clinical and imaging data of 17 patients with 30 intracranial aneurysms treated with LFD in the Interventional Radiology Department of the Affiliated Taizhou People′s Hospital of Nanjing Medical University from January 2023 to May 2024.Imaging follow-up was performed 6 months after operation,and the occlusion of aneurysms was evaluated according to the O′Kelly-Marotta(OKM)grading system.Results A total of 17 LFDs were implanted in 30 aneurysms of 17 patients(15 cases with simple LFD implantation and 2 cases with LFD combined with coil embolization),and the surgical success rate was 17/17.Two LFDs poorly adhered to the wall during operation,and one of them even presented filling defect at the distal end.They improved after symptomatic treatment.No patient suffered surgery-related cerebral ischemia or cerebral hemorrhage after surgery.Imaging follow-up was performed 6 months after operation in 11 patients(17 aneurysms).Among them,15 aneurysms achieved healing with OKM grade D.one aneurysm showed shrinkage with OKM grade B,and the aneurysm disappeared one year later.one case was an internal carotid artery dissection aneurysm,and 6 months after operation showed no obvious change compared with before,with OKM grade A.One patient was found to have severe stenosis of the artery during follow-up but had no obvious cerebral ischemia manifestation.Conclusion Preliminary observations show that LFD is safe and effective in treating intracranial aneurysms.
作者
刘善凯
石月
张大忠
刘剑宇
殷建林
Liu Shankai;Shi Yue;Zhang Dazhong;Liu Jianyu;Yin Jianlin(Department of Interventional Radiology,the Affiliated Taizhou People′s Hospital of Nanjing Medical University,Taizhou 225300,China;Department of Anesthesiology,the Affiliated Taizhou People′s Hospital of Nanjing Medical University,Taizhou 225300,China)
出处
《中华神经外科杂志》
北大核心
2025年第5期494-498,共5页
Chinese Journal of Neurosurgery
