摘要
目的研究LEO Baby支架在颅内远端小血管动脉瘤介入治疗中的有效性及安全性。方法回顾性分析自2019年3月至2020年3月南京医科大学金陵临床医学院(东部战区总医院)神经外科使用LEO Baby支架辅助治疗的38例患者共42个动脉瘤的临床资料。应用LEO Baby支架半释放技术辅助栓塞动脉瘤,采用Raymond-Roy分级评价术后即刻及随访时动脉瘤栓塞程度。术后1个月门诊随访并复查头部CT,术后3个月复查脑血管MR血管成像,术后6个月复查DSA。出院时及术后6个月时采用改良Rankin量表评估患者预后。结果38例中,男22例,女16例;平均年龄(58±11)岁;前交通动脉动脉瘤20个,大脑前动脉瘤7个,大脑中动脉M1分叉部动脉瘤14个,大脑后动脉瘤1个。42个动脉瘤共使用40枚LEO Baby支架辅助治疗。97.5%(39/40)的支架成功释放。78.6%(33/42)的动脉瘤达到了Raymond-Roy分级Ⅰ/Ⅱ级栓塞。术中4例发生支架内血栓,术后3例发生症状性缺血性事件,给予替罗非班后均无神经功能缺损。无1例发生围手术期颅内出血。36例进行临床随访,中位随访时间4.5(1.0,7.0)个月,1例术后脑梗死患者死亡,1例术前Hunt-Hess分级Ⅴ级患者术后2个月仍呈植物状态,余随访病例均未见神经功能减退;22例影像学随访均未见动脉瘤复发。结论LEO Baby支架辅助治疗颅内小血管动脉瘤安全有效。
Objective To investigate the safety and efficacy of LEO Baby stents for the treatment of intracranial aneurysms located in distal small arteries.Methods From March 2019 to March 2020,the clinical data of 42 intracranial aneurysms in 38 patients treated with LEO Baby stent in the Department of Neurosurgery,School of Medicine,Jinling Hospital,Nanjing Medical University(General Hospital of Eastern Theater Command)were retrospectively analyzed.LEO Baby stent semi-release technology was used to assist aneurysm embolization and Raymond-Roy classification was used to evaluate the degree of aneurysm embolization immediately after operation and during follow-up.Outpatient follow-up was conducted 1 month after operation and head CT was rechecked.Cerebral MR angiography was rechecked 3 months after the operation,and DSA was rechecked 6 months after the operation.The prognosis was assessed by the modified Rankin scale(mRS)at discharge and 6 months postoperatively.Results Of the 38 cases,22 were male and 16 were female.The mean age was(58±11)years old.There were 20 anterior communicating artery aneurysms,7 anterior cerebral artery aneurysms,14 middle cerebral artery M1 bifurcation aneurysms,and 1 posterior cerebral artery aneurysm.A total of 40 LEO Baby stents were used to assist the treatment of 42 aneurysms.97.5%(39/40)stent was successfully released.Raymond-Roy(R-R)ⅠorⅡocclusion were achieved in 78.6%(33/42)of the aneurysms.Intraoperative thrombosis occurred in 4 cases,and postoperative symptomatic ischemic events occurred in 3 cases.There was no neurological impairment after tirofiban administration.No intracranial hemorrhage occurred perioperatively.During a mean follow-up duration of 4.5(1.0,7.0)months in 36 patients.1 patient died of cerebral infarction after intervention,and 1 patient with preoperative Hunt-Hess grade V was still in a vegetative state 2 months after intervention.No neurological function degeneration was observed in the remaining patients.No aneurysm recurrence was found in 22 cases with angiograp
作者
唐晓宇
文立利
吴琪
张安
周龙江
张鑫
Tang Xiaoyu;Wen Lili;Wu Qi;Zhang An;Zhou Longjiang;Zhang Xin(Department of Neurosurgery,School of Medicine,Jinling Hospital,Nanjing Medical University(General Hospital of Eastern Theater Command),Nanjing 210002,China)
出处
《中国脑血管病杂志》
CAS
CSCD
北大核心
2020年第9期538-542,共5页
Chinese Journal of Cerebrovascular Diseases
