摘要
目的分析内支架辅助治疗颅内动脉瘤的并发症,探讨降低并发症的方法。方法 2009年6月至2012年3月收治38例颅内动脉瘤患者,其中曾有蛛网膜下腔出血17例,无出血史21例;颅内单发动脉瘤26例,多发动脉瘤12例,总计50枚动脉瘤中,位于前交通动脉11枚,后交通动脉17枚,大脑中动脉8枚,椎动脉5枚,颈内动脉床突段9枚。在对38例50枚动脉瘤的介入治疗中,采用单纯弹簧圈栓塞4枚,单纯支架覆盖12枚,支架辅助弹簧圈栓塞34枚,其中使用LEO支架27枚,Neuroform支架16枚,Solitaire支架3枚。结果 38例患者的50枚动脉瘤中,对46枚行支架治疗,动脉瘤内支架辅助治疗的总并发症率为19.6%(9/46),包括术中动脉瘤破裂出血3例,支架诱发血栓形成5例(均为LEO支架),致支架移位1例,术后发生脑梗死致偏瘫2例,因并发肺部感染死亡1例;术中支架打开不良1例。结论颅内动脉瘤的内支架辅助治疗有较高的脑血管并发症,需要加强内支架辅助治疗的围手术期管理,以减低并发症发生率和改善并发症患者的预后。
Objective To analyze the complications of endovascular stentassited management for intracranial aneurysms, and to discuss the practical way to reduce the complications. Methods During the period from Jun. 2009 to Mar. 2012, a total of 38 patients with intracranial aneurysms were admitted to authors＇ hospital. Of the 38 patients, 17 had a history of subarachnoid hemorrhage and 21 had no subarachnoid hemorrhage before. The lesions included single intracranial aneurysm （n = 26） and multiple intracranial aneurysms （n = 12）. A total of 50 intracranial aneurysm were detected, which were located at anterior communicating artery （n = 11）, posterior communicating artery （n = 17）, middle cerebral artery （n = 8） vertebral artery （n = 5） and the clinoid process segment of internal carotid artery （n = 9）. In the whole interventional management for 38 patients, pure coils （n = 4）, pure stent implantation （n = 12） or stent-assited coils （n = 34） were employed. The stents used included LEO （n = 27）, Neuroform （n = 16） and Solitaire （n = 3）. The complications were recorded and the results were analyzed. Results Of the 50 aneurysms in the 38 patients, stenting treatment was carried out in 46. The total incidence of complications in stent- assited management for intracranial aneurysms was 19.6% （9/46）. The complications included intracranial bleeding due to aneurysm rupture occurring during operation （n = 3）, stent-induced thrombosis （n = 5）, stent displacement （n = 1）, postoperative hemiparalysis caused by cerebral infarction （n = 2）, death due to pulmonary infection （n = 1 ） and poor opening of the stent （n = 1 ）. Conclusion Stent-assited management for intracranial aneurysms carries rather high incidence of cerebrovascular complications. Therefore, careful perioperative management is essentially needed in order to reduce the occurrence of complications as well as to improve the patient＇s prognosis.
出处
《介入放射学杂志》
CSCD
北大核心
2012年第11期885-889,共5页
Journal of Interventional Radiology
关键词
颅内动脉瘤
支架
并发症
intracranial aneurysm
stent
complication
