| 颈内动脉多发宽颈动脉瘤的介入治疗分析 |
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| 引用本文： | 李治国,水少锋,韩新巍,闫,磊,马,骥,郭,栋,李腾飞,袁慧锋.颈内动脉多发宽颈动脉瘤的介入治疗分析[J].中国临床神经外科杂志,2019,0(8):453-456. |
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| 作者姓名： | 李治国 水少锋 韩新巍 闫 磊 马 骥 郭 栋 李腾飞 袁慧锋 |
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| 作者单位： | 450000 郑州，郑州大学第一附属医院介入科（李治国、水少锋、韩新巍、闫 磊、马 骥、郭 栋、李腾飞、袁慧锋） |
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| 摘 要： | 目的 探讨颈内动脉多发宽颈动脉瘤的介入治疗方法及临床效果。方法 回顾性分析2016年5月至2018年12月介入治疗的32例（67枚）颈内动脉多发宽颈动脉瘤的临床资料。微导管穿支架网眼进入动脉瘤腔栓塞11例；微导管先置入动脉瘤腔后释放支架进行栓塞12例；支架半释放法栓塞4例；密网支架置入覆盖动脉瘤颈5例。67枚动脉瘤中，55枚采用支架辅助栓塞；1枚在处理临近眼动脉段动脉瘤时以支架覆盖；11枚行密网支架覆盖瘤颈。结果 术后即时造影证实支架辅助栓塞55枚中，Raymond分级Ⅰ级49枚，Ⅱ级6枚；5例11枚动脉瘤行密网支架治疗，术后即时造影均显示动脉瘤内血流减缓，造影剂滞留。术中出现动脉瘤破裂出血1例，部分弹簧圈突出于支架内1例，支架置入后打开不全2例。30例共63枚动脉瘤进行3~6个月（平均3.4个月）造影随访；49枚完全栓塞的动脉瘤中，46枚没有变化，3枚瘤颈区少量显影。6枚近全栓塞动脉瘤中，3枚转为完全栓塞，3枚没变化；1枚仅支架覆盖的眼动脉段小动脉瘤形态无变化；3例共7枚动脉瘤行密网支架治疗，复查造影显示瘤体显影减小，造影剂明显滞留；2例共4枚动脉瘤密网支架置入术治疗后尚未复查。30例术后临床随访3~6个月，改良Rankin量表评分0分23例，1分5例，2分2例；预后良好率为93.33%（28/30）。结论 根据载瘤血管及多发动脉瘤具体情况，采用多种支架辅助栓塞治疗颈内动脉多发宽颈动脉瘤，近期随访均可取得较高的动脉瘤栓塞率及较好的临床预后。
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| 关 键 词： | 颅内多发动脉瘤 宽颈动脉瘤 颈内动脉 介入治疗 支架辅助 |
Analysis of stent-assisted intervenient treatment of multiple wide-necked aneurysms of internal carotid arteries |
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| LI Zhi-guo,SHUI Shao-feng,HAN Xin-wei,YAN Lei,MA Ji,GUO Dong,LI Teng-fei,YUAN Hui-feng.Analysis of stent-assisted intervenient treatment of multiple wide-necked aneurysms of internal carotid arteries[J].Chinese Journal of Clinical Neurosurgery,2019,0(8):453-456. |
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| Authors: | LI Zhi-guo SHUI Shao-feng HAN Xin-wei YAN Lei MA Ji GUO Dong LI Teng-fei YUAN Hui-feng |
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| Affiliation: | Department of Intervenient Radiology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China |
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| Abstract: | Objective To explore the technique and clinical outcomes of stent-assisted coils endovascular embolization of the multiple wide-necked aneurysms (MWNA) of the internal carotid arteries (ICA). Methods Thirty-two patients with 67 ICA MWNA were treated by stent-assisted coils endovascular embolization in our department from May, 2016 to December, 2018.The embolization effects were assessed by Raymond grading . DSA was performed again in 30 patients 3 or 6 months after the therapy, when modified Rankin scale score (mRS) was used to evaluate the clinical effects. Results DSA showed immediately after the treatment that of 67 aneurysms, 49 received Raymond grade Ⅰ occlusion (complete occlusion), 6 Raymond grade Ⅱ (subtotal occlusion ), 1 was covered with one ordinary stent and 11 received the covering of the aneurismal necks with dense mesh stents . The prognosis belonged in mRS 0 point in 23, mRS 1 point in 5 and mRS 2 points in 2 of 30 patients followed up 3 or 6 months after the treatment. The patients without neurological function disturbance accounted for 93.33% (30/32) of all the patients followed up. DSA 3 or 6 months after the embolization showed that no MWNA recurred in all the patients and the cavities of all aneurysms reduced in 3 patients treated with dense mesh stents. Conclusion The short-term curative effects of stent-assisted coil endovascular embolization on MWNA are good. |
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| Keywords: | Multiple intracranial aneurysms Intervenient treatment Stent-assisted coil embolization Internal carotid artery |
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