学术背景:随着神经介入医学的不断发展,带膜支架在神经介入中的优越性越来越被认可,其应用也越来越受到重视。目的:介绍带膜支架的材料类型,总结带膜支架在神经介入中的应用现状及不足之处。检索策略:由该论文的研究人员应用计算机检索Pubmed数据库的相关文献资料,以“stentgraft,covered stents,cerebrovascular disease”为检索词,共检索到223篇相关文献,应用维普数据库以“带膜支架,脑血管疾病”作为检索词,共找到196篇中文文献。对资料进行初审,纳入标准:①与带膜支架在神经介入中的应用密切相关,特别是脑血管介入密切相关。②近期发表或是权威杂志上发表的文章。排除标准:重复性研究。文献评价:计算机初检得到223篇英文相关文献,中文文献196篇,阅读标题及进行初筛,排除重复性研究,共纳入31篇文献,综述4篇,基础研究3篇,其余为临床研究。资料综合:因带膜支架在神经介入治疗中所体现出的独特优越性,该支架正在成为研究的热点。带膜支架在出血性脑血管疾病中的应用,目前均为个案或小宗病例报道。已有报道说明应用带膜支架可有效的闭塞动脉瘤、夹层动脉瘤、动静脉瘘等病变,且能保持载瘤动脉通畅。带膜支架以膜性物理屏障隔离溃疡斑块,避免了栓子脱落,有可能进一步减少经皮颈内动脉支架置入术过程中的栓塞事件的发生。并且带膜支架释放后,聚四氟乙烯膜使管壁更加光滑,其良好的生物相容性,使血栓形成减少,进而使管腔再狭窄的发生率减低。尽管血管内带膜支架用于脑血管病的治疗已取得了显著的效果,但应用中也存在一些问题:①带膜支架最主要的缺陷是闭塞它所覆盖范围的分支小血管。②覆膜支架置入术后的血栓形成及再狭窄问题。③覆膜材料增加了支架的体积,减少了支架的顺应性和柔韧性,加大了推送的难度及对血管损伤的可能性。④血管直径小于4mm,不适宜使用带膜支架。结论:带膜支架在颅内缺血性和出血性疾病的应用中正日益显示出其显著的疗效,但也有其不足之处。随着相关理论研究的深入及新材料工艺的进步,带膜支架在脑血管疾病治疗中的应用将会更加广泛。 Academic background: With the continuous development of neuroin interventional medicine, the superiority of stent-graft in nerve intervention is more and more recognized, and its application is more and more attention. OBJECTIVE: To introduce the material types of stent-graft and summarize the application status and shortcomings of stent-graft in nerve intervention. Retrieval strategies: The researchers used the computer to search the Pubmed database for related literatures. Totally 223 related articles were retrieved using the term “stentgraft, covered stents, cerebrovascular disease” Membrane stents, cerebrovascular disease "as a search term, a total of 196 Chinese articles were found. Preliminary review of the data, included in the standard: ① and stent-graft in the application of nerve involvement are closely related, especially in cerebrovascular intervention is closely related. ② recently published or authoritative magazine published articles. Exclusion criteria: Repeatability study. Literature evaluation: 223 English articles, 196 Chinese articles were read by computer, and the titles were read and preliminary screening was conducted. Repeated studies were excluded. A total of 31 articles were included, 4 were reviewed, 3 were basic research, and the rest were clinical studies. DATA SYNTHESIS: This scaffold is becoming a hot spot for research because of the unique advantages that stent-grafts have in neurosurgical interventions. The use of stents with stents in hemorrhagic cerebrovascular disease is currently reported on a case-by-case or case-by-case basis. It has been reported that the application of stent-graft can effectively block aneurysm, dissecting aneurysm, arteriovenous fistula and other lesions, and can maintain the parent artery patency. Membrane-based stent with membranous barrier to isolate the ulcer plaque, to avoid the emboli off, may further reduce the occurrence of percutaneous carotid artery stenting embolization occurred. And the release of the stent with a stent, the Teflon membrane to make the wall more smooth, its good biocompatibility, so that thrombosis decreased, thereby reducing the incidence of restenosis. Although the use of endovascular stent-graft in the treatment of cerebrovascular disease has achieved remarkable results, there are some problems in its application: ① The main defect of the stent-graft is the occlusion of the small blood vessels that it covers. ② stent graft stent thrombosis and restenosis. ③ coating material to increase the volume of the stent, reducing the compliance and flexibility of the stent, increasing the difficulty of pushing and the possibility of vascular damage. ④ vascular diameter less than 4mm, unsuitable for use with stent-graft. CONCLUSION: Stent-coated stents are increasingly showing significant efficacy in the treatment of intracranial ischemic and hemorrhagic diseases, but there are also deficiencies. With the deepening of relevant theoretical research and the progress of new materials and technology, the application of stents with stents in the treatment of cerebrovascular diseases will be more extensive.