CAJ | 학술논문

目的探讨Waffle cone技术栓塞颅内动脉瘤的初步经验.方法回顾性分析2010年12月至2012年8月郑州大学一附院介入科支架辅助颅内动脉瘤栓塞的病例中,应用Waffle cone技术患者的资料.根据术前患者的临床情况(Hunt-Hess分级)、颅内动脉瘤以及术后围手术恢复期、随访情况,总结分析该技术的安全性及合理应用时机.结果共138例支架辅助下颅内动脉瘤填塞,其中应用Waffle cone技术6例;病例均为颅内动脉分叉口、宽径动脉瘤,远端分支血管均从瘤体接近瘤径处以锐角发出.6例均为急性破裂动脉瘤,分别位于基底动脉顶端2例、前交通动脉3例和大脑中动脉分叉部1例.术中栓塞程度Raymond Class分级Ⅰ级4例,Ⅱ级2例.围手术期无并发症.随访时间平均6个月,无再发出血.结论颅内动脉分叉处宽颈动脉瘤、远端分支血管以锐角自瘤体发出的、尤其急性期破裂动脉瘤,Waffle cone技术不失为一种可供选择的治疗技术,它有较高的时效性,操作相对简单、安全程度也较高.近期疗效满意,远期疗效仍有待进一步随访.
목적 탐토Waffle cone기술전새로내동맥류적초보경험.방법 회고성분석2010년12월지2012년8월정주대학일부원개입과지가보조로내동맥류전새적병례중,응용Waffle cone기술환자적자료.근거술전환자적림상정황(Hunt-Hess분급)、로내동맥류이급술후위수술회복기、수방정황,총결분석해기술적안전성급합리응용시궤.결과 공138례지가보조하로내동맥류전새,기중응용Waffle cone기술6례;병례균위로내동맥분차구、관경동맥류,원단분지혈관균종류체접근류경처이예각발출.6례균위급성파렬동맥류,분별위우기저동맥정단2례、전교통동맥3례화대뇌중동맥분차부1례.술중전새정도Raymond Class분급Ⅰ급4례,Ⅱ급2례.위수술기무병발증.수방시간평균6개월,무재발출혈.결론 로내동맥분차처관경동맥류、원단분지혈관이예각자류체발출적、우기급성기파렬동맥류,Waffle cone기술불실위일충가공선택적치료기술,타유교고적시효성,조작상대간단、안전정도야교고.근기료효만의,원기료효잉유대진일보수방.
Objective To explore the preliminary experiences of "Waffle cone" technique for the treatment of intracranial aneurysm.Methods Retrospective data analyses were performed for patients with intracranial aneurysms embolized by the "Waffle cone" technique from stent-assisted coiling at our hospital from December 2010 to November 2012.Results Six patients used the "Waffle cone" technique from 138 stent-assisted coiling.All had complex wide-neck bifurcation cerebral aneurysms.And the angles between parental artery and distal vessels were acute.Six rupture aneurysms were at the terminus of basilar artery (BA) (n =2),right anterior communicating artery (AcomA) (n =3) and trifurcation middle cerebral artery (MCA) (n =1).All stents were of Solitaire with specification 4 × 15 mm(ev3,USA).Four patients had Raymond classification Class Ⅰ while another 2 Class Ⅱ.No perioperative complication occurred.The average follow-up period was 6 months.Conclusion This technique is safe,time-saving,simple and effective for complex,wide-necked bifurcation aneurysms with acute angles between parental artery and distal vessels.Long-term follow-ups are needed to further evaluate its efficacy.