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中华神经创伤外科电子杂志

中华神经创伤外科电子杂志 ›› 2020, Vol. 06 ›› Issue (02) : 95 -99. doi: 10.3877/cma.j.issn.2095-9141.2020.02.007

所属专题： 文献；

临床研究

LVIS支架辅助弹簧圈栓塞在颅内宽颈破裂动脉瘤治疗中的应用
王湘赣1, 周洪龙1, 祝新根1, 毛国华1,†()   
  1. 1. 360000　南昌，南昌大学第二附属医院神经外科
  • 收稿日期:2019-12-26 出版日期:2020-04-15
  • 通信作者: 毛国华
  • 基金资助:
    江西省科技厅社发领域重点项目(20161BBG70209)

Application of LVIS stent assisted coil embolization in the treatment of intracranial wide neck ruptured aneurysms

Xianggan Wang1, Honglong Zhou1, Xingen Zhu1, Guohua Mao1,†()   

  1. 1. Department of Neurosurgery, the Second Affiliated Hospital of Nanchang University, Nanchang 360000, China
  • Received:2019-12-26 Published:2020-04-15
  • Corresponding author: Guohua Mao
  • About author:
    Corresponding author: Mao Guohua, Email:
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引用本文：

王湘赣, 周洪龙, 祝新根, 毛国华. LVIS支架辅助弹簧圈栓塞在颅内宽颈破裂动脉瘤治疗中的应用[J]. 中华神经创伤外科电子杂志, 2020, 06(02): 95-99.

Xianggan Wang, Honglong Zhou, Xingen Zhu, Guohua Mao. Application of LVIS stent assisted coil embolization in the treatment of intracranial wide neck ruptured aneurysms[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2020, 06(02): 95-99.

目的

分析低剖面可视化腔内支撑装置（LVIS）支架辅助弹簧圈栓塞在颅内宽颈破裂动脉瘤治疗应用中的安全性和有效性。

方法

回顾性分析南昌大学第二附属医院神经外科自2016年7月至2017年7月收治的行LVIS支架辅助弹簧圈栓塞治疗的43例颅内宽颈破裂动脉瘤伴蛛网膜下腔出血患者。采用改良Raymond分级标准评价术后即刻的栓塞结果以及术后6个月第1次的动脉瘤随访闭塞程度；采用改良Rankin评分（mRs）评估患者预后疗效情况。

结果

43例颅内宽颈破裂动脉瘤伴蛛网膜下腔出血患者动脉瘤共47枚，其中2例（4.6%）患者为多发动脉瘤，均成功栓塞。43例动脉瘤患者中1例（2.3%）出现术中动脉瘤破裂出血，2例（4.6%）术中出现支架内急性血栓；术后即刻闭塞情况：Ⅰ级栓塞35例（81.4%），Ⅱ级6例（13.9%），Ⅲ级2例（4.7%）；术后6个月随访结果：Ⅰ级栓塞40例（93.0%），Ⅱ级2例（7.0%），1例（2.3%）复发，后期予再栓塞治疗；术后1年mRs评分为0~2分有41例（95.3%）。

结论

LVIS支架辅助下栓塞颅内宽颈破裂动脉瘤是安全、有效的治疗方法，但长期疗效仍需要进一步验证。

关键词: 颅内宽颈破裂动脉瘤, 低剖面可视化腔内支撑装置支架, 支架辅助弹簧圈介入栓塞
Objective

Analyze the safety and effectiveness of low-profile visualized intraluminal support (LVIS) stent-assisted coil embolization in the treatment of intracranial wide neck ruptured aneurysms.

Methods

Forty-three patients with subarachnoid hemorrhage caused by wide neck ruptured aneurysm treated with LVIS stent-assisted coil embolization in the Department of Neurosurgery, the Second Affiliated Hospital of Nanchang University from July 2016 to July 2017 were analyzed retrospectively. The modified Raymond classification standard was used to evaluate the embolization results and the degree of occlusion of the most recent aneurysm immediately after surgery and 6 months after surgery. The modified Rankin score (mRs) was used to evaluate the postoperative efficacy of the patients.

Results

There were 47 aneurysms in 43 patients with intracranial wide neck ruptured aneurysms and subarachnoid hemorrhage, 2(4.6%) patients were multiple aneurysms, all of which were successfully embolized. In 43 patients with aneurysms, 1(2.3%) had ruptured aneurysm and bleeding during operation, and 2(4.6%) had acute thrombus in stent during operation; immediate occlusion after operation: 35 (81.4%) patients with grade Ⅰ embolization, 6 (13.9%) patients with grade Ⅱ embolization, and 2 (4.7%) patients with grade Ⅲ embolization; 6-month follow-up results: 40 (93.0%) patients with grade Ⅰ embolization, 2 (7.0%) patients with grade Ⅱ embolization, 1 (2.3%) had relapse, and they were re-embolized later 41 (95.3%) cases had mRs score of 0-2 in 1 year after operation.

Conclusion

LVIS stent-assisted coil embolization is a safe and effective treatment for intracranial wide-neck ruptured aneurysms. Further long term follow-up studies will be necessary to confirm its long-term efficacy.

Key words: Intracranial wide neck rupture aneurysm, Low-profile visualized intraluminal support, Stent-assisted coil embolization
图1 典型病例术前术后的影像学资料
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