LVIS支架辅助栓塞颅内破裂动脉瘤的有效性和安全性

目的：分析Lvis支架辅助栓塞颅内破裂动脉瘤的有效性及安全性。 方法：回顾性分析2014年4月至2018年2月在郑州大学第一附属医院神经介入科接受Lvis支架辅助栓塞颅内破裂动脉瘤的230例患者的临床资料，分析患者术后即刻的疗效及随访疗效，收集围手术期并发症发生情况，分析其出血事件发生率、缺血事件发生率、致死率和残疾率。 结果：230例患者术后即刻手术效果：Raymond Ⅰ级205例（89.1%），Raymond Ⅱ级25例（10.9%）。术后12个月，180例患者获得随访，临床效果：Raymond Ⅰ级162例（90%），Raymond Ⅱ级17例（9.6%），Raymond Ⅲ级1例（0.4%）。230例患者发生并发症共计24例（14.0%），1例（0.4%）术中动脉瘤破裂再出血，1例（0.4%）术后出现再出血，12例（5.2%）术中或术后支架内血栓，支架内血栓患者中3例（1.2%）出现缺血并发症，术后未发现支架内血栓或闭塞患者出现缺血并发症患者10例（4.3%），所有并发症患者中出现8例致残（3.5%），致死2例（0.8%）。 结论：Lvis支架辅助栓塞颅内破裂动脉瘤安全有效。

Analysis the efficacy and safety of endovascular treatment of ruptured intracranial aneurysms with the LVIS device

Objective:To evaluste the clinical efficacy and safety of the LVIS stent for embolization of ruptured intracranial saccular aneurysms. Methods:A total of 230 patients with ruptured intracranial saccular aneurysms treated using the LVIS device in our center between April 2014 and February 2018 were reviewed. The primary outcomes were procedural safety, target aneurysm recurrence, and mid-term follow-up of clinical and angiographic outcomes. Results:230 patients with intracranial saccular aneurysms were treated using LVIS stents, no failed. Immediate angiographic outcome evaluation showed complete occlusion in 205 (89%) and neck remnant in 25 (11%) . Of the 180 patients who underwent angiographic follow-up at a mean of 12 months, complete occlusion was achieved in 162 (90%) patients. In the remaining patients, neck remnant in 17 (9.4%) and 1 (0.6%) patient were recurrence. There were 24 cases of complications. 1 case of bleeding event, 1 case of rebleeding event. 12 (5.2%) patients had in-stent thrombosis in the process of embolization and 3 patients had ischemia events. And the ischemia events was 10 after operation. The morbality rate was 3.5% and mortality was 0.8% of all the complications. Conclusions:The LVIS stent is safe and effective in the treatment of ruptured intracranial saccular aneurysms.