介入放射学杂志
介入放射學雜誌
개입방사학잡지
JOURNAL OF INTERVENTIONAL RADIOLOGY
2010年
4期
263-268
,共6页
孙贞魁%李永东%李明华%谭华桥%王武%罗七一%程英升
孫貞魁%李永東%李明華%譚華橋%王武%囉七一%程英升
손정괴%리영동%리명화%담화교%왕무%라칠일%정영승
数字减影血管造影%颈内动脉%支架
數字減影血管造影%頸內動脈%支架
수자감영혈관조영%경내동맥%지가
digital subtraction angiography%internal carotid artery%covered stent
目的 评价Willis覆膜支架治疗颅段颈内动脉(ICA)动脉瘤的柔顺性和疗效.方法 31例患者33枚颅段ICA(CICA)动脉瘤患者接受Willis覆膜支架治疗.根据血管造影表现,分为完全栓塞和不完全栓塞.术后第1,3,6,12个月及之后每年1次随访复查并收集最初及最终造影结果 、死亡率、致残率及最终临床结果 等数据.结果 42枚覆膜支架中41枚顺利通过ICA并成功释放,成功率97.6%(95%CI:93%~102%).术后即刻造影显示,23例患者中25枚为完全栓塞,占78.1%(95%CI:63%~93%);7例患者7枚动脉瘤为不完全栓塞(21.9%).随访血管造影示27例患者共31枚动脉瘤,其中29枚完全栓塞,占93.5%(95%CI:84%~103%);2例为不完全栓塞(6.5%),其中2例患者出现轻度支架内狭窄.临床随访显示15例患者痊愈,14例症状改善.结论 初步结果显示,Willis覆膜支架治疗CICA动脉瘤有效且具有良好的柔顺性,但仍需长期随访及大样本临床研究.
目的 評價Willis覆膜支架治療顱段頸內動脈(ICA)動脈瘤的柔順性和療效.方法 31例患者33枚顱段ICA(CICA)動脈瘤患者接受Willis覆膜支架治療.根據血管造影錶現,分為完全栓塞和不完全栓塞.術後第1,3,6,12箇月及之後每年1次隨訪複查併收集最初及最終造影結果 、死亡率、緻殘率及最終臨床結果 等數據.結果 42枚覆膜支架中41枚順利通過ICA併成功釋放,成功率97.6%(95%CI:93%~102%).術後即刻造影顯示,23例患者中25枚為完全栓塞,佔78.1%(95%CI:63%~93%);7例患者7枚動脈瘤為不完全栓塞(21.9%).隨訪血管造影示27例患者共31枚動脈瘤,其中29枚完全栓塞,佔93.5%(95%CI:84%~103%);2例為不完全栓塞(6.5%),其中2例患者齣現輕度支架內狹窄.臨床隨訪顯示15例患者痊愈,14例癥狀改善.結論 初步結果顯示,Willis覆膜支架治療CICA動脈瘤有效且具有良好的柔順性,但仍需長期隨訪及大樣本臨床研究.
목적 평개Willis복막지가치료로단경내동맥(ICA)동맥류적유순성화료효.방법 31례환자33매로단ICA(CICA)동맥류환자접수Willis복막지가치료.근거혈관조영표현,분위완전전새화불완전전새.술후제1,3,6,12개월급지후매년1차수방복사병수집최초급최종조영결과 、사망솔、치잔솔급최종림상결과 등수거.결과 42매복막지가중41매순리통과ICA병성공석방,성공솔97.6%(95%CI:93%~102%).술후즉각조영현시,23례환자중25매위완전전새,점78.1%(95%CI:63%~93%);7례환자7매동맥류위불완전전새(21.9%).수방혈관조영시27례환자공31매동맥류,기중29매완전전새,점93.5%(95%CI:84%~103%);2례위불완전전새(6.5%),기중2례환자출현경도지가내협착.림상수방현시15례환자전유,14례증상개선.결론 초보결과현시,Willis복막지가치료CICA동맥류유효차구유량호적유순성,단잉수장기수방급대양본림상연구.
Objective To evaluate the flexibility and efficacy of the Willis covered stent in the treatment of distal internal carotid artery(DICA)aneurysms.Methods The study was approved by the anthors' institutional review board,and the research was conducted by the authors' institution and the MicroPort Medical Company(Shanghai,China).Thirty-one patients with 33 DICA aneurysms were considered for treatment with a Willis covered stent.The angiographic assessments were categorized as complete or incomplete occlusion.The data on technical Success,initial and final angiographic results,mortality,morbidity,and final clinical outcome were collected,and follow-up was performed at 1,3,6,and 12 months and yearly after the procedures.Results Navigation and deployment of the covered stents were succssfnl in 97.6%(41 of 42;95%confidence interval[CI]:93%,102%)of the attempted stent placement procedures.The initial angiographic results showed a complete occlusion in 23 patients with 25 aneurysms(of 32 aneurysms,78.1%[95%CI:63%,93%])and an incomplete occlusion in seven patients with seven aneurysms(21.9%).The angiographic follow-up(mean,14 months[95% CI:12,15 months])findings exhibited a complete occlusion in 27 patients with 29 aneurysms(of 31 aneurysms,93.5%[95%CI:84%,103%])and an incomplete occlusion in two aneurysms(6.5%),with a mild in-stent stenosis in two patients.The clinical follow-up(mean,27 months[95% CI:23,30 months])demonstrated that 15 patients experienced a full recovery and 14 patients improved.Conclusion The preliminary results demonstrate good flexibility and efficacy of the Willis covered stent in the treatment of DICA aneurysms in selected patients:longer follow-up and expanded clinical trials are needed.