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目的探讨应用自膨胀式颅内专用支架(Neuroform 支架)与可解脱微弹簧圈(GDC)栓塞相结合治疗宽颈颅内动脉瘤技术的临床应用价值。方法采用 Neuroform 支架与 GDC 结合栓塞治疗30例基底动脉宽颈动脉瘤(基底动脉末端动脉瘤16例、基底动脉干9例、基底动脉起始部5例),30例后交通宽颈动脉瘤,5例椎动脉宽颈动脉瘤。通过微导管释放 Neuroform 支架覆盖动脉瘤瘤颈,将另一微导管通过支架网孔进入动脉瘤腔以 GDC 栓塞动脉瘤。结果全部病例采用 Neuroform 支架结合 GDC 栓塞,支架均顺利通过载瘤动脉,覆盖瘤颈,其中60例致密栓塞,5例部分栓塞。2例术中发生支架内血栓。全部患者均恢复良好出院。42例术后3～6个月血管造影随访,其中39例致密栓塞的动脉瘤均未显影,载瘤动脉通畅;3例动脉瘤颈有残留。结论 Neuroform 颅内支架使用方便、安全,适用于颅内宽颈动脉瘤的支架辅助 GDC 栓塞。
Objective To explore the clinical value of the application of self-expanding intracranial stent (Neuroform stent) and detachable microcoil (GDC) embolization in the treatment of wide-necked intracranial aneurysm. Methods 30 cases of basilar artery wide neck aneurysm (16 cases of basilar artery aneurysm, 9 cases of basilar artery, 5 cases of basilar artery origin) and 30 cases of wide-necked posterior communicating artery aneurysm were treated with Neuroform stent combined with GDC. 5 cases of wide-necked vertebral artery aneurysm. The Neuroform stent was released through the microcatheter to cover the aneurysm neck and another microcatheter was passed through the stent mesh into the aneurysm cavity to embolize the aneurysm with GDC. Results All cases were treated with Neuroform stent combined with GDC embolization. The stent passed the parent artery and covered the tumor neck. Among them, 60 were densely embolized and 5 were partially embolized. Intraoperative stent thrombosis occurred in 2 cases. All patients recovered well discharged. Forty-two patients were followed up for angiography 3 to 6 months after operation. Among them, 39 aneurysms with dense embolism were not developed and the parent artery was unobstructed; 3 cases had residual aneurysm neck. Conclusion The use of the Neuroform intracranial stent is convenient and safe, and is suitable for the stent-assisted GDC embolization of wide-necked intracranial aneurysms.