LVIS支架在后循环动脉瘤中的应用
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Application of LVIS stents in posterior-circulation aneurysms
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    摘要:

    目的 总结讨论LVIS支架在栓塞治疗后循环动脉瘤的应用经验和体会。方法 回顾性分析我院使用LVIS支架辅助栓塞后循环动脉瘤的24例临床资料并进行随访。结果 24例均成功栓塞。24例患者共使用支架35枚,其中LVIS支架32枚。其中单纯使用双LVIS支架覆盖4例,使用单LVIS支架辅助弹簧圈栓塞13例,Enterprise支架+LVIS支架辅助弹簧圈栓塞3例,双LVIS支架辅助弹簧圈栓塞4例。支架置入成功率100%,2例出现尾端打开不良经使用支架导管按摩后张开良好。支架覆盖动脉的分支动脉未见减少或缩窄。未发生支架内狭窄或载瘤动脉闭塞。栓塞结束后行常规造影检查按照改良的Raymond分级评定。其中I级18例,Ⅱ级2例,Ⅲ级4例。术中破裂1例。术后并发急性脑梗塞1例。出院时按格拉斯哥预后GOS评分5分17例,4分1例,3分2例,2分3例,1分1例。13例介入复查1例复发。结论 LVIS支架在后循环动脉瘤中应用安全,能够达到较好的治疗效果。

    Abstract:

    Objective To summarize the experience in the application of LVIS stents in embolization therapy for posterior-circulation aneurysms. Methods A retrospective analysis was performed for the clinical data of 24 patients with posterior-circulation aneurysms who underwent LVIS stent-assisted embolization and were followed up in our hospital. Results All 24 patients underwent successful embolization. A total of 35 stents were used in the 24 patients, including 32 LVIS stents. Of all patients, 4 received dual LVIS stents alone, 13 received single LVIS stent-assisted coil embolization, 3 received Enterprise stent+LVIS stent-assisted coil embolization, and 4 received dual LVIS stent-assisted coil embolization. The success rate of stent implantation was 100%, and there were 2 cases of poor opening of the tail end, which were opened well after massage with stent catheter. No reduction or constriction was observed in the arterial branches covered by the stents. No in-stent stenosis or occlusion of the artery with aneurysm was observed. Routine radiographic examination was performed according to the modified Raymond classification after embolization, and the results showed grade I in 18 patients, grade Ⅱ in 2 patients, and grade Ⅲ in 4 patients. Intraoperative rupture was observed in 1 patient, and postoperative acute cerebral infarction was observed in 1 patient. At the time of discharge, the Glasgow Outcome Scale score was 5 points in 17 patients, 4 points in 1 patient, 3 points in 2 patients, 2 points in 3 patients, and 1 point in 1 patient. Among the 13 patients who underwent reexamination, 1 experienced recurrence. Conclusions LVIS stents are safe and effective in the treatment of posterior-circulation aneurysms and can achieve good outcomes.

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李小辉, 黄戈, 冯正健, 姜盛强, 何锦浪, 李智斌, 伍益456. LVIS支架在后循环动脉瘤中的应用[J].国际神经病学神经外科学杂志,2019,46(2):172-175111LI Xiaohui, HUANG Ge, FENG Zhengjian, JIANG Shengqiang, HE Jinlang, LI Zhibin, WU Yi222. Application of LVIS stents in posterior-circulation aneurysms[J]. Journal of International Neurology and Neurosurgery,2019,46(2):172-175

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  • 收稿日期:2019-01-13
  • 最后修改日期:2019-03-15
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  • 在线发布日期: 2019-04-28
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