摘要
目的观察使用Pipeline Flex血流导向装置(PED)治疗颅内动脉瘤的疗效及安全性。方法回顾性分析2020年6月至2022年6月中山市人民医院使用PED治疗的25例颅内动脉瘤(共29个动脉瘤)患者的临床资料,25例患者中2例存在2个串联动脉瘤,1例有3个串联动脉瘤。29个动脉瘤分布在颈内动脉26个,大脑中动脉1个,椎基底动脉2个。术后进行临床及影像学随访,评估术后即刻动脉瘤栓塞情况和出院时患者改良Rankin评分量表(mRS),并在术后6个月及12个月时随访进行影像学检查以明确动脉瘤闭塞情况。结果25例患者均成功置入PED,其中15个动脉瘤联合弹簧圈栓塞,14个动脉瘤单独置入PED支架。术中有1例使用球囊扩张,24例经导丝微导管按摩均贴壁良好,术后临床随访中1例(4%)患者有缺血症状。术后6个月随访22个(75.9%)动脉瘤完全闭合,术后12个月随访2个(6.9%)动脉瘤影像学随访中未见闭合,27个(93.1%)动脉瘤完全闭合。结论PED治疗颅内动脉瘤短期随访安全有效,并发症较少,动脉瘤闭塞率较高。
Objective To observe the efficacy and safety of the Pipeline Flex embolization device(PED)in the treatment of intracranial aneurysms.Methods The clinical data of 25 patients with intracranial aneurysms(29 aneurysms in total)treated with PED in Zhongshan People's Hospital from June 2020 to June 2022 were retrospectively analyzed,including 2 patients with 2 tandem aneurysms and 1 patient with 3 tandem aneurysms.Among the 29 aneurysms,26 were located in 26 internal carotid arteries,1 in middle cerebral artery,and 2 in vertebrobasilar arteries.Postoperative clinical and imaging follow-up was performed to assess the aneurysm embolization immediately after operation and patients'modified Rankin Scale(mRS)at discharge,and imaging examination was performed at 6 and 12 months postoperatively to clarify aneurysm occlusion.Results PED were successfully placed in the 25 patients,including 15 aneurysms combined with coil embolization and 14 aneurysms with PED stents alone.During operation,1 case used balloon dilation,and 24 cases were well apposed by guidewire microcatheter massage.One patient(4%)had ischemic symptoms in postoperative clinical follow-up.At 6 months after surgery,22(75.9%)aneurysms were completely closed.At 12 months after surgery,2(6.9%)aneurysms were not closed in imaging follow-up,and 27(93.1%)aneurysms were completely closed.Conclusion PED for intracranial aneurysm was safe and effective in short-term follow-up,with fewer complications and higher aneurysm occlusion rate.
作者
谢兵
韩昊锦
李锐韬
韩志安
丁明祥
XIE Bing;HAN Hao-jin;LI Rui-tao;HAN Zhi-an;DING Ming-xiang(Department of Cerebrovascular Intervention,Zhongshan People's Hospital,Zhongshan 528400,Guangdong,CHINA)
出处
《海南医学》
CAS
2024年第1期39-42,共4页
Hainan Medical Journal
基金
广东省中山市医学科研基金(编号:2022J165)。
关键词
颅内动脉瘤
血流导向装置
治疗效果
并发症
Intracranial aneurysm
Pipeline embolization device
Therapeutic effect
Complications
