摘要
目的探讨Pipeline血流导向装置对治疗复杂脑动脉瘤手术并发症的影响。方法回顾性分析2015年1月至2016年10月，接受Pipeline血流导向装置治疗的53例患者共70枚动脉瘤的临床及影像资料。采用logistic回归模型分析动脉瘤位置、大小、类型及是否辅助使用弹簧圈等因素对并发症的影响。结果53例患者均成功置入Pipeline血流导向装置58枚，其中26例患者仅单纯植入Pipeline血流导向装置，27例患者瘤腔内辅助弹簧圈栓塞。围手术期发生并发症5例（9.4%，5/53），其中致残性和致死性并发症各1例；手术1个月后再发并发症2例（3.8%，2/53），1例脑梗死、1例脑实质出血，均为非致残性。Logistic回归模型分析显示动脉瘤位置（P=1.00）、类型（梭性，P=1.00；夹层，P=1.00）、大小（P=0.59）、是否使用弹簧圈（P=0.53）在并发症发生中差异无统计学意义。其中43例（58枚动脉瘤）患者术后中位影像随访时间为6个月（3～19个月），次全以上闭塞43枚（74.1%，43/58）；3例患者出现载瘤动脉狭窄，但均未出现明显缺血症状。结论Pipeline血流导向装置治疗国人复杂脑动脉瘤闭塞率高，但如何更好地预防并发症仍需进一步研究。
ObjectiveTo evaluate the complications of the Pipeline embolization device in treating complex cerebral aneurysm.MethodsConsecutive data of 53 patients who suffered from complex cerebral aneurysm and underwent Pipeline device treatment were retrospectively collected and analyzed. Clinical and imaging data including aneurysm location, type, size and the using of coils, were recorded to investigate the complications.ResultsPipeline embolization device was successfully implanted, and 27 patients were combined with coils. Five complications occurred in the 1-month perioperative stage, of which, 1 was disable and 1 was fatal. Two non-disability complications occurred in the later stage beyond 1 month, of which, 1 was cerebral infraction and 1 was intraparenchymal hemorrhage. The Logistic regression analysis demonstrated that the posterior circulation location, types, large size and the using of coils were not statistically significant risk factors for complications. The median imaging follow-up for 43 patients with 58 aneurysms was 6 months, the complete and sub-complete occlusion rate of aneurysms was 74.1% （43/58） and 3 non-symptomatic stenosis occurred in the patients with Pipeline embolization device.ConclusionsThe occlusion rate of Pipeline embolization device in treating Chinese complex cerebral aneurysm is high, but another further research should be done for the mechanism and the prevention methods of the complications.
作者
白卫星
李天晓
许予明
李航
贺迎坤
Bai Weixing;Li Tianxiao;Xu Yuming;Li Hang;He Yingkun(Department of Neurology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2018年第10期779-783,共5页
Chinese Journal of Radiology
基金
国家自然科学基金（81601583）
国家“十三五”重点研发计划（2016YFC1300702）
河南省科技攻关项目（162102310268,172102310509）
关键词
颅内动脉瘤
放射学
介入性
手术后并发症
Intracranial aneurysm
Radiology
interventional
Postoperative complications
