中国卒中杂志Issue(11)：862-867,6.
支架治疗介入栓塞术后复发颅内动脉瘤的回顾性研究
Use of Stents in Repeat Endovascular Treatment of Post-embolization Recurrent Intracranial Aneurysms
张照龙 1赵文元 1刘建民 1杨鹏飞 1封灏 1李强 1方亦斌 1杨志刚 1黄清海 1许奕 1洪波1
作者信息
- 1. 200433 上海第二军医大学附属长海医院临床神经医学中心、神经外科
- 折叠
摘要
Abstract
Objective To evaluate the feasibility, effectiveness, and safety of recurrent aneurysm treatment with stent. <br> Methods A retrospective review was conducted for 83 patients with recurrent intracranial aneurysms who underwent endovascular treatment with stent in Department of Neurosurgery, Changhai Hospital, between June 2006 and March 2013. <br> Results For these 83 patients with recurrent aneurysms, 93 stents were deployed successfully, and 10 patients received dual stent placement. Among them, 33 patients were treated with stent placement alone and 50 patients received stent-assisted coil embolization. In the patients treated with stent placement alone, residual iflling of contrast medium in the aneurysms was seen in 18 patients (54.5%) immediately after the stent placement. However, no obvious difference was seen in 15 patients (45.5%). Of the 50 aneurysms treated with stent-assisted embolization, complete occlusion was achieved in 11 aneurysms (22.0%);residual neck remained in 21 aneurysms (42.0%), and residual aneurysm was present in 18 aneurysms (36.0%). Procedure-related complication occurred in 2 patients. They both suffered vasospasm and was discharged with no deifcit. The modiifed Rankin Scale (mRS) score at discharge was 0~2 in 82 patients (98.8%) and 3 in one patient (1.2%). Follow-up angiographies were available in 50 (60.2%) patients (ranging 2~52 months, median 11 months). The results of 20 patients treated by stent placement alone showed complete occlusion in 14 (70.0%), progressive occlusion in 3 (15.0%) and stable in 3 (15.0%). Follow-up of 30 patients treated by stent assisted coil embolization showed complete occlusion in 20 (66.7%), progressive occlusion in 3 (10.0%), stable in 3 (10.0%), minor recanalization in 2 (6.7%), major recanalization in 1 (3.3%) and rerupture in 1 (3.3%). The clinical follow-up (ranging 2~82 months, median 30 months) demonstrated no neurologic deterioration except the one suffering SAH, who received endovascular treatment again without neurologic deifcit. <br> Conclusion The treatment of recurrent intracranial aneurysms with stents can be successfully achieved with satisfactory midterm results.关键词
动脉瘤/复发/支架/治疗/预后Key words
Aneurysm/Recurrence/Stent/Treatment/Prognosis引用本文复制引用
张照龙,赵文元,刘建民,杨鹏飞,封灏,李强,方亦斌,杨志刚,黄清海,许奕,洪波..支架治疗介入栓塞术后复发颅内动脉瘤的回顾性研究[J].中国卒中杂志,2013,(11):862-867,6.
