[1]王 钢,雷 超,温大平,等.低剖面可视化腔内支撑支架辅助弹簧圈栓塞术治疗急性期破裂颅内宽颈动脉瘤疗效研究[J].陕西医学杂志,2023,52(2):154-157.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.008]
　WANG Gang,LEI Chao,WEN Daping,et al.Efficacy of lowprofile visualization endovascular stent assisted coil embolization in treatment of acute ruptured intracranial wide necked aneurysms[J].,2023,52(2):154-157.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.008]
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低剖面可视化腔内支撑支架辅助弹簧圈栓塞术治疗急性期破裂颅内宽颈动脉瘤疗效研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年2期
页码:
154-157
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Efficacy of lowprofile visualization endovascular stent assisted coil embolization in treatment of acute ruptured intracranial wide necked aneurysms
作者:
王 钢; 雷 超; 温大平; 杭 军
(西安市第一医院神经外科,陕西 西安 710002)
Author(s):
WANG Gang; LEI Chao; WEN Daping; HANG Jun
(Department of Neurosurgery,Xi'an No.1 Hospital,Xi'an 710002,China)
关键词:
动脉瘤;  破裂;  支架;  栓塞;  急性期;  并发症
Keywords:
Aneurysm;  Rupture;  Stent;  Embolization;  Acute phase;  Complications
分类号:
R 651.122
DOI:
DOI:10.3969/j.issn.1000-7377.2023.02.008
文献标志码:
A
摘要:
目的:探讨低剖面可视化腔内支撑支架(LVIS)辅助弹簧圈栓塞术治疗急性期破裂颅内宽颈动脉瘤的临床疗效及并发症。方法:回顾性研究实施 Solitaire 支架辅助弹簧圈栓塞与LVIS支架辅助弹簧圈栓塞术治疗的急性期破裂颅内宽颈动脉瘤患者108例的临床、影像学资料,其中观察组53例实施LVIS支架辅助弹簧圈治疗; 对照组55例实施Solitaire支架辅助弹簧圈治疗。对比两组手术效果、并发症及患者出院时和随访6个月后的疗效。结果:术后即刻和术后12 个月时观察组Raymond 分级均优于对照组(P<0.05)。观察组53例中,有6例出现了围术期并发症,发生率为11.32%,对照组有15例出现相关并发症,发生率则是27.27%,两组对比有统计学差异(P<0.05)。术后随访6～14个月,平均(7.76±3.52)个月,观察组预后良好率为75.47%,对照组为56.36%,两组比较差异有统计学意义(P<0.05)。结论:LVIS支架辅助弹簧圈栓塞术在急性期破裂颅内宽颈动脉瘤患者治疗中具有较高的安全性。
Abstract:
Objective:To investigate the efficacy of lowprofile visualization endovascular stent(LVIS)assisted coil embolization in the treatment of acute ruptured intracranial wide necked aneurysms.Methods:The clinical and imaging data of 108 patients with acute ruptured intracranial wide necked aneurysms who received LVIS stent assisted coil embolization or Solitaire stent assisted coil embolization were retrospectively studied.The observation group was treated with LVIS stent assisted coil therapy(53 cases)and the control group was treated with Solitaire stent assisted coil therapy(55 cases).The operative effect,complications and the curative effect of the patients at discharge and after 6 months of follow-up were analyzed.Results:Raymond score of the observation group was better than that of the control group immediately after operation and 12 months after operation(all P<0.05).Of the 53 patients in the observation group,6 cases(11.32%)had perioperative complications,15 cases(27.27%)in the control group had related complications.There was a significant difference in the incidence of complications between the two groups(P<0.05).The follow-up period ranged from 6 to 14 months with an average of(7.76±3.52)months.The good prognosis rate was 75.47% in the observation group and 56.36% in the control group,and the difference was statistically significant(P<0.05).Conclusion:LVIS stent assisted coil embolization for acute ruptured intracranial wide necked aneurysms is safe and effective.

参考文献/References:

[1] 黄蔚文,赵岳峰.血管内介入栓塞术治疗前循环破裂颅内动脉瘤临床疗效及预后危险因素分析[J].陕西医学杂志,2020,49(4):446-449,457.
[2] 叶 妮,王 钢,温大平,等.早期中医康复介入对脑出血病人功能及生活能力恢复的影响[J].陕西中医,2020,41(9):1205-1207.
[3] 张小曦,左 乔,刘建民,等.支架辅助弹簧圈栓塞术和单纯弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤安全性的比较[J].第二军医大学学报,2018,39(2):124-128.
[4] Chung J,Lim YC,Suh SH,et al.Stent-assisted coil embolization of ruptured wide-necked aneurysms in the acute period:Incidence of and risk factors for periprocedural complications[J].Journal of Neurosurgery,2014,121(1):4-11.
[5] 李淦诚,张 炘,范海燕,等.支架辅助弹簧圈栓塞治疗颅内动脉瘤围手术期并发症的危险因素分析[J].中华神经医学杂志,2019,18(2):136-143.
[6] 张锡武,江 澈,赵 刚,等.Enterprise支架辅助弹簧圈栓塞治疗颅内动脉瘤的并发症分析[J].中国微侵袭神经外科杂志,2020,25(4):164-167.
[7] 李文帅,张信芳,徐文涛,等.LVIS支架辅助栓塞急性期破裂颅内宽颈动脉瘤[J].中华神经外科杂志,2018,34(1):50-54.
[8] 田 涛,彭汤明,万伟锋,等.LVIS支架联合弹簧圈栓塞急性期颅内破裂宽颈动脉瘤的临床疗效[J].中国脑血管病杂志,2018,15(5):248-253.
[9] Liu Y,Wang F,Wang M,et al.Comparison of stent-assisted coil placement and coiling-only for the treatment of ruptured intracranial aneurysms[J].Med Sci Monit,2017,23:5697-5704.
[10] 梁晓东,王子亮,李天晓,等.支架辅助栓塞颅内未破裂动脉瘤三种抗血小板方案围手术期并发症发生率比较[J].中华放射学杂志,2016,50(7):531-536.
[11] 张 亮,宋 英,韩 光,等.TEG检测对颅内动脉瘤破裂支架辅助栓塞术病人围术期抗凝药物应用的临床价值[J].山东医药,2020,60(13):65-67.
[12] 刘鹏程,罗有才.颅内自膨式支架系统辅助弹簧圈栓塞术治疗颅内宽颈动脉瘤近期疗效观察[J].陕西医学杂志,2019,48(8):1056-1058.
[13] 陈俊臣,任晓乐,李 倩,等.解痉汤治疗动脉瘤性蛛网膜下腔出血后脑血管痉挛临床研究[J].陕西中医,2020,41(8):1055-1058.
[14] Ryu CW,Park S,Shin HS,et al.Complications in stent-assisted endovascular therapy of ruptured intracranial aneurysms and relevance to antiplatelet administration:A systematic review [J].AJNR,2015,36(9):1682-1688.
[15] 黄志伟,李学东,覃 军,等.支架辅助栓塞急性期颅内宽颈破裂动脉瘤的并发症危险因素分析[J].中华神经外科杂志,2016,32(4):380-384.
[16] Chen Y,Zhang Y,Chao YJ,et al.Stent-assisted coiling embolization of middle cerebral artery trifurcation wide-necked aneurysms[J].Eur Rev Med Pharmacol Sci,2017,21(19):4346-4349.
[17] 康俊龙,田新华,吴启锋,等.颅内动脉瘤破裂急性期LVIS支架辅助弹簧圈栓塞治疗分析[J].中华危重病急救医学,2020,32(7):828-834.
[18] 张 波,叶 明,陈圣攀,等.LVIS支架在血管内治疗颅内宽颈动脉瘤中的应用[J].中华神经外科杂志,2015,31(10):1011-1014.
[19] Wang JW,Li XY,Li CH,et al.Safety and efficacy of the low-profile visualized intraluminal support stent in treating intracranial atherosclerotic stenosis[J].Neurologia(Engl Ed),2021,9:213-223.
[20] Wang X,Xing H,Cai J,et al.The safety and efficacy of the LVIS stent for the treatment of ruptured intracranial aneurysms within 24 hours:A multicenter retrospective study[J].Clin Neurol Neurosurg,2020,197:106117.

备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2018SF-143)
更新日期/Last Update: 2023-02-06