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目的探讨和总结颅内宽颈动脉瘤应用Neuroform自膨式支架结合弹簧圈治疗的新技术,评价Neuroform自膨式支架的顺应性、结合弹簧圈治疗的有效性。方法回顾性分析采用Neuroform自膨式支架结合弹簧圈新技术治疗的30例颅内宽颈动脉瘤患者的疗效,30例患者的平均动脉瘤大小为9·5mm。在微导丝导引下推送Neuroform支架组合体,跨骑动脉瘤颈释放支架,其中一期支架辅助弹簧圈治疗动脉瘤20例,二期支架结合弹簧圈栓塞动脉瘤10例。结果30例患者中术中完全栓塞21例(70%),大部分栓塞9例(30%)。术后支架移位2例,血栓性栓塞1例。术后临床随访29例,仅1例遗留永久性轻偏瘫;21例术后6~12个月经数字减影血管造影显示,7例动脉瘤残留需行二次治疗,其中4例第2次达到了完全栓塞。结论支架辅助弹簧圈栓塞新技术提高了颅内宽颈动脉瘤的近期疗效,但长期疗效尚有待临床及血管造影随访结果来证实。
Objective To discuss and summarize the new technology of Neuroform self-expanding stent combined with coil for evaluating intracranial wide-necked aneurysms and evaluate the compliance of Neuroform self-expanding stent combined with the effectiveness of coil. Methods Thirty patients with wide-necked intracranial aneurysms treated with Neuroform self-expandable stent combined with coil spring technique were retrospectively analyzed. The mean aneurysm size of 30 patients was 9.5 mm. Under the guide of micro-guide, the Neuroform scaffold assembly was pushed and the aneurysm neck was released. One of the scaffold auxiliary coils was used to treat aneurysm in 20 cases. The second stent was combined with coil embolization aneurysm in 10 cases. Results Among the 30 patients, 21 cases (70%) were completely embolized during operation, and 9 cases (30%) had embolization. Postoperative stent displacement in 2 cases, thrombosis embolism in 1 case. Postoperative clinical follow-up of 29 cases, only 1 case of permanent left hemiparesis left; 21 cases of 6 to 12 months after digital subtraction angiography showed that 7 cases of aneurysm residual need to be treated twice, of which 4 cases reached the second Complete embolism. Conclusion The new technique of stent-assisted coil embolization improves the short-term curative effect of wide-necked intracranial aneurysms. However, long-term curative effect remains to be confirmed by clinical and angiographic follow-up results.