摘要
颅内动脉瘤为颅内动脉血管壁上的异常膨出,其破裂是导致蛛网膜下腔出血的首要原因,具有较高的致死率和致残率。传统的治疗方式包括开颅夹闭术和血管内介入治疗,但针对大型、巨大型、梭形或宽颈动脉瘤,这些传统方法往往面临巨大挑战。血流导向密网支架(Flow Diverter,FD)的出现代表了颅内动脉瘤治疗理念的一次革命性转变——从传统的瘤内填塞转向载瘤动脉的重建。FD是一种高金属覆盖率、低孔隙率的密网支架,通过置于动脉瘤瘤颈口,可显著改变瘤内血流动力学,促进血流停滞和瘤内血栓形成,并作为支架促进内皮细胞爬行,最终实现动脉瘤的完全闭塞和载瘤动脉的生理性重建。本文旨在系统回顾FD从理念提出到临床实践的发展历程,阐述其作用机制,分析当前临床有效性与安全性,并对其未来的发展方向进行展望。
Intracranial aneurysm refers to an abnormal bulging on the wall of intracranial arteries.Its rupture is the main cause of non-traumatic subarachnoid hemorrhage,with extremely high mortality and disability rates.Traditional treatment methods include craniotomy with clipping and endovascular interventional therapy.However,these conventional approaches often face significant challenges when dealing with large,giant,fusiform,or wide-necked aneurysms.The emergence of flow diverter(FD)represents a revolutionary shift in the treatment concept of intracranial aneurysms,moving from traditional endosaccular packing to the reconstruction of the parent artery.As a type of dense-mesh stent with high metal coverage and low porosity,FD is placed at the neck of the aneurysm to significantly alter the intraluminal hemodynamics of the aneurysm,promote blood flow stasis and intraneurysmal thrombosis.Meanwhile,acting as a scaffold,FD facilitates endothelial cell migration and proliferation,ultimately achieving complete occlusion of the aneurysm and physiological reconstruction of the parent artery.This article aimed to systematically review the development process of FD devices from the proposal of the concept to clinical practice,elaborate on their mechanism of action in detail,analyze its clinical effectiveness and safety,and provide an outlook on their future development directions.
作者
董硕
吴萍
荣瑶
吴航
DONG Shuo;WU Ping;RONG Yao;WU Hang(Department of Medical Engineering,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国医疗设备》
2025年第12期12-18,24,共8页
China Medical Devices
基金
《中国医疗设备》杂志社课题(2025-CMDKT-01-001)。
