两种支架在颅内宽颈动脉瘤栓塞术中的应用比较

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1、两种支架在颅内宽颈动脉瘤栓塞术中的应用比较尹剑张松吕庆平陈怀金许洪段传志杭州市红十字会医院神经外科南方医科大学珠江医院神经外科摘要：目的比较两种支架辅助下栓塞颅内宽颈动脉瘤的安全性和有效性。方法lH

2、顾性分析54例共62个宽颈动脉瘤病人的临床资料，采用经颅内支架半释放或后释放技术辅助下弹簧圈栓塞治疗。其中釆用Enterprise支架29例(Enterprise组)，采用Solitaire支架25例(Solitaire组)。比较两组动脉癖栓塞情况以及围手术期并发症等情况。结果本组54例病例共植入70枚颅内支架，其中Enterprise支架38枚，Solitaire支架32枚。所有支架成

3、功释放，W组频内动脉瘤栓塞效果差异无统计学意义(Z=-0.016,P=0.988)。围手术期并发症:Enterprise组5例，Solitaire组3例。两组总并发症的发生率差异无统计学意义(x2=0.194,P=0.907)。出院时改良Rankin(mRS)评分:0分26例，1分16例，2分8例，3分4例。两组出院mRS评分差异无统计学意义(Z=-0.299,P=0.765)。随访236个月，所有病人恢复良好，未见再次颅内出血或新发脑梗死灶。结论两种颅内支架辅助下栓塞颅内宽颈动脉瘤技术可操作性强，安全性高，应根据载瘤动脉形态与动脉瘤颈特点，合理选用支架类型。关键词：颅内动脉瘤，宽颈

4、;支架，颅内;魅弹簧圈;收稿日期：2017-04-01基金：杭州市科学技术委员会资助项S(编号:20150633B28)Acomparativestudyoftwoself-expandingstentsforembolizationofintracranialwideneckaneurysmsYinJianZhangSongLvQingpingChenHuaiJinXuhongDuanChuanzhiDepartmentofNeurosurgery,RedCrossHospitalofHangzhou;DepartmentofNeurosurgery，ZhujiangHospita

5、l，SouthernMedicalUniversity;Abstract：ObjectiveTocomparethesafetyandefficacyoftwodifferentintracranialstentsincoilembolizationfortheintracranialwideneckaneurysms.MethodsClinicaldataof54patientswith62wide-neckaneurysmswereanalyzedretrospectively,whoreceivedintracranialstentsemi-deployingorpost-de

6、ployingtechnique-assistedcoilembolization.Twenty-ninepatientsweretreatedwithEnterprisestentsasEnterprisegroupand25withSolitairestentsasSolitairegroup.Theintraoperativeembolizationandperioperativecomplicationswereanalyzedandcomparedbetweenthetwogroups.ResultsTherewere70stentsimplantedincluding38

7、Enterprisestentsand32Solitairestents.Allthestentsweredeployedsuccessfully.Therewasnosignificantdifferenceinembolizationoutcomebetweentwogroups(Z=-0.016，P=0.988).Perioperativecomplicationsoccurredin5patientsinEnterprisegroupand3inSolitairegroup.Therewerenosignificantdifferencesintheincidenceofpe

8、rioperativecomplicationsbetweenthetwogroups(x2=0.194,P=0.907)•ThemodifiedRankinscale(mRS)scorewere0in26patients,1in16，2in8and3in4atdischarge.TherewerenosignificantdifferencesinmRSscoresbetweenthetwogroups(Z=~0.299,P=0.765).Allthep