切换至 "中华医学电子期刊资源库"

中华神经创伤外科电子杂志 ›› 2023, Vol. 09 ›› Issue (06) : 381 -384. doi: 10.3877/cma.j.issn.2095-9141.2023.06.012

教学视频

Pipeline支架治疗颅脑创伤后颅内大型动脉瘤
刘珍, 乔卫东, 王辉, 李钢()   
  1. 572000 三亚,三亚中心医院(海南省第三人民医院)神经外科
  • 收稿日期:2023-11-05 出版日期:2023-12-15
  • 通信作者: 李钢
  • 基金资助:
    海南省自然科学基金(822RC874)

Pipeline stent treatment for large intracranial aneurysms after traumatic brain injury

Zhen Liu, Weidong Qiao, Hui Wang   

  • Received:2023-11-05 Published:2023-12-15
引用本文:

刘珍, 乔卫东, 王辉, 李钢. Pipeline支架治疗颅脑创伤后颅内大型动脉瘤[J]. 中华神经创伤外科电子杂志, 2023, 09(06): 381-384.

Zhen Liu, Weidong Qiao, Hui Wang. Pipeline stent treatment for large intracranial aneurysms after traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(06): 381-384.

颅内创伤性动脉瘤属于假性动脉瘤,传统的开颅夹闭和血管内介入栓塞存在一定的风险和复发率。以Pipeline支架为代表的血流导向装置可以重建载瘤动脉血流和隔绝动脉瘤,达到动脉瘤治愈的目标。本文报道1例在颅脑损伤后20年诊断为颈内动脉大型动脉瘤的患者,经单枚Pipeline支架治疗后动脉瘤完全愈合,治疗效果满意。

图1 右侧颈内动脉床突段动脉瘤患者术前影像学资料A:骨窗可见右侧鞍旁骨质紊乱;B:脑窗可见右侧鞍旁稍高密度影;C:右侧颈内动脉床突段动脉瘤CT扫描(轴位);D:右侧颈内动脉床突段动脉瘤CT扫描(冠状位);E:三维重建可见游离的右侧前床突压迫颈内动脉C7段;F:术前DSA检查可见右侧颈内动脉大型动脉瘤
Fig.1 Preoperative imaging data of a patient with right internal carotid artery clinoid segment aneurysm
图2 右侧颈内动脉床突段动脉瘤患者术后影像学资料A~B:Pipeline支架释放后即刻DSA图;C~D:术后6个月DSA示动脉瘤不显影,载瘤动脉通畅;E~F:术后6个月CTA示动脉瘤痊愈,载瘤动脉通畅,颈动脉床突段存在局限性骨性狭窄
Fig.2 Postoperative imaging data of right internal carotid artery clinoid segment aneurysm in patients
[1]
Szikora I, Berentei Z, Kulcsar Z, et al. Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the pipeline embolization device[J]. AJNR Am J Neuroradiol, 2010, 31(6): 1139-1147. DOI: 10.3174/ajnr.A2023.
[2]
Wong GK, Kwan MC, Ng RY, et al. Flow diverters for treatment of intracranial aneurysms: current status and ongoing clinical trials[J]. J Clin Neurosci, 2011, 18(6): 737-740. DOI: 10.1016/j.jocn.2010.10.011.
[3]
卢昊,胡鹏,张鸿祺,等. Pipeline栓塞装置治疗颅内未破裂动脉瘤的短期疗效[J].中华神经外科杂志, 2017, 33(8): 785-789. DOI: 10.3760/cma.j.issn.1001-2346.2017.08.007.
[4]
Kallmes DF, Ding YH, Dai D, et al. A new endoluminal, flow-disrupting device for treatment of saccular aneurysms[J]. Stroke, 2007, 38(8): 2346-2352. DOI: 10.1161/strokeaha.106.479576.
[5]
Becske T, Brinjikji W, Potts MB, et al. Long-term clinical and angiographic outcomes following pipeline embolization device treatment of complex internal carotid artery aneurysms: five-year results of the pipeline for uncoilable or failed aneurysms trial[J]. Neurosurgery, 2017, 80(1): 40-48. DOI: 10.1093/neuros/nyw014.
[6]
中国医师协会神经介入专业委员会出血性脑血管病神经介入专业委员会(学组),中国医师协会神经外科医师分会神经介入专业委员会,中国医师协会介入医师分会神经介入专业委员会.血流导向装置治疗颅内动脉瘤的中国专家共识[J].中华神经外科杂志, 2020, 36(5): 433-445. DOI: 10.3760/cma.j.cn112050-20200229-00089.
[7]
Marosfoi M, Langan ET, Strittmatter L, et al. In situ tissue engineering: Endothelial growth patterns as a function of flow diverter design[J]. J Neurointerv Surg, 2017, 9(10): 994-998. DOI: 10.1136/neurintsurg-2016-012669.
[8]
Hong Y, Wang YJ, Deng Z, et al. Stent-assisted coiling versus coiling in treatment of intracranial aneurysm: a systematic review and meta-analysis[J]. PLoS One, 2014, 9(1): e82311. DOI: 10.1371/journal.pone.0082311.
[9]
King B, Vaziri S, Singla A, et al. Clinical and angiographic outcomes after stent-assisted coiling of cerebral aneurysms with enterprise and Neuroform stents: a comparative analysis of the literature[J]. J Neurointerv Surg, 2015, 7(12): 905-909. DOI: 10.1136/neurintsurg-2014-011457.
[10]
Li H, Gao BL, Li CH, et al. Endovascular retreatment of cerebral aneurysms previously treated with endovascular embolization[J]. J Neurol Surg A Cent Eur Neurosurg, 2020, 81(3): 207-212. DOI: 10.1055/s-0039-1685513.
[11]
Chalouhi N, Tjoumakaris S, Gonzalez LF, et al. Coiling of large and giant aneurysms: complications and long-term results of 334 cases[J]. AJNR Am J Neuroradiol, 2014, 35(3): 546-552. DOI: 10.3174/ajnr.A3696.
[12]
李航,贺迎坤,白卫星,等. Pipeline血流导向装置治疗复杂颅内动脉瘤的安全性及中期疗效[J].中华神经外科杂志, 2018, 34(5): 442-446. DOI: 10.3760/cma.j.issn.1001-2346.2018.05.003.
[13]
Becske T, Kallmes DF, Saatci I, et al. Pipeline for uncoilable or failed aneurysms: results from a multicenter clinical trial[J]. Radiology, 2013, 267(3): 858-868. DOI: 10.1148/radiol.13120099.
[14]
Aguilar-Salinas P, Brasiliense LB, Gonsales D, et al. Evaluation of pipeline flex delivery system for the treatment of unruptured aneurysms[J]. Expert Rev Med Devices, 2016, 13(10): 885-897. DOI: 10.1080/17434440.2016.1231573.
[15]
Saatci I, Yavuz K, Ozer C, et al. Treatment of intracranial aneurysms using the pipeline flow-diverter embolization device: a single-center experience with long-term follow-up results[J]. AJNR Am J Neuroradiol, 2012, 33(8): 1436-1446. DOI: 10.3174/ajnr.A3246.
[1] 梁德双, 邓桥, 冯文峰. 依替巴肽治疗Pipeline密网支架置入后急性血栓形成的剂量策略[J]. 中华脑科疾病与康复杂志(电子版), 2019, 09(04): 222-226.
[2] 陈中国, 万宇婷, 陈卓萍, 陈晓君, 袁亚君. CPR技术在颅内血流导向装置植入术中的应用[J]. 中华介入放射学电子杂志, 2023, 11(03): 247-250.
[3] 陈爱霞, 吴培, 吴桥伟, 李俞辰, 胡旭晨, 姚金彪, 陈平伯, 史怀璋, 王跃华. 单纯血流导向装置治疗椎-基底动脉动脉瘤的安全性及疗效分析[J]. 中华介入放射学电子杂志, 2023, 11(03): 241-246.
[4] 矫健, 李汶翰, 罗瀚, 袁亚君, 王文毫, 刘汉伟, 于本帅. Pipeline血流导向装置与传统支架辅助栓塞治疗颈内动脉未破裂中小型动脉瘤的疗效比较分析[J]. 中华介入放射学电子杂志, 2023, 11(03): 223-229.
[5] 赖和泰, 刘羽, 程光森, 刘永康, 李忠亮, 陆骊工. 39例Surpass Streamline治疗未破裂动脉瘤患者诊疗分析:单中心临床经验[J]. 中华介入放射学电子杂志, 2023, 11(01): 19-24.
[6] 孙世蒙, 李天晓, 李立, 邵秋季, 常凯涛, 吴桥伟. 国产Tubridge血流导向装置治疗椎动脉夹层动脉瘤的初步应用[J]. 中华介入放射学电子杂志, 2021, 09(02): 160-164.
[7] 吴桥伟, 李立, 邵秋季, 李天晓, 贺迎坤, 常凯涛, 白卫星. Pipeline Flex血流导向装置治疗颅内复杂动脉瘤的安全性及短期疗效[J]. 中华介入放射学电子杂志, 2020, 08(01): 28-32.
[8] 连万成, 姚京, 吴泽涛, 何毅, 伍健明, 张猛. 血流导向装置治疗颅内未破裂动脉瘤的疗效与影响因素分析[J]. 中华脑血管病杂志(电子版), 2023, 17(01): 31-36.
阅读次数
全文


摘要