中国神经精神疾病杂志
中國神經精神疾病雜誌
중국신경정신질병잡지
CHINESE JOURNAL OF NERVOUS AND MENTAL DISEASES
2015年
8期
492-496
,共5页
伍健伟%何伟文%梁建峰%江顺婷
伍健偉%何偉文%樑建峰%江順婷
오건위%하위문%량건봉%강순정
颅内宽颈动脉瘤%支架%介入治疗%疗效
顱內寬頸動脈瘤%支架%介入治療%療效
로내관경동맥류%지가%개입치료%료효
Stent%Stent-assisted%Wide-necked intracranial aneurysms%Intervention treatment%Efficacy Com-plication
目的：探讨颅内破裂宽颈动脉瘤急性期支架辅助栓塞治疗的有效性和安全性。方法回顾连续纳入178例患者192个宽颈动脉瘤，对比分析支架辅助栓塞宽颈破裂和未破裂动脉瘤的疗效。结果破裂动脉瘤78个，未破裂动脉瘤114个，支架植入成功率100%，破裂动脉瘤组与未破裂动脉瘤组手术相关并发症分别14.1%和6.1%（χ2=3.456，P＞0.05），死亡和永久致残发生率分别8.9%和6.1%（χ2=0.475，P＞0.05），差异无统计学意义。出院时破裂动脉瘤患者发生不良预后明显较未破裂动脉瘤患者常见（23.1%vs.5%，χ2=12.726，P＜0.001）。平均随访14.7个月，脑血管造影复查破裂动脉瘤组和未破裂动脉瘤组动脉瘤完全闭塞率分别74.1%和70.6%（χ2=0.197，P＞0.05）；动脉瘤复发率分别10.3%和9.4%（χ2=0.034，P＞0.05）；支架内血管狭窄发生率分别3.4%和4.7%（χ2=0.136，P＞0.05）；差异无统计学意义。结论破裂宽颈动脉瘤急性期支架辅助栓塞治疗，长期随访动脉瘤完全闭塞率、动脉瘤再通率及支架内血管狭窄率与未破裂动脉瘤结果相近。但是，破裂动脉瘤患者发生不良预后较为常见，手术相关并发症有较未破裂动脉瘤患者高的倾向，因此仍需慎用。
目的：探討顱內破裂寬頸動脈瘤急性期支架輔助栓塞治療的有效性和安全性。方法迴顧連續納入178例患者192箇寬頸動脈瘤，對比分析支架輔助栓塞寬頸破裂和未破裂動脈瘤的療效。結果破裂動脈瘤78箇，未破裂動脈瘤114箇，支架植入成功率100%，破裂動脈瘤組與未破裂動脈瘤組手術相關併髮癥分彆14.1%和6.1%（χ2=3.456，P＞0.05），死亡和永久緻殘髮生率分彆8.9%和6.1%（χ2=0.475，P＞0.05），差異無統計學意義。齣院時破裂動脈瘤患者髮生不良預後明顯較未破裂動脈瘤患者常見（23.1%vs.5%，χ2=12.726，P＜0.001）。平均隨訪14.7箇月，腦血管造影複查破裂動脈瘤組和未破裂動脈瘤組動脈瘤完全閉塞率分彆74.1%和70.6%（χ2=0.197，P＞0.05）；動脈瘤複髮率分彆10.3%和9.4%（χ2=0.034，P＞0.05）；支架內血管狹窄髮生率分彆3.4%和4.7%（χ2=0.136，P＞0.05）；差異無統計學意義。結論破裂寬頸動脈瘤急性期支架輔助栓塞治療，長期隨訪動脈瘤完全閉塞率、動脈瘤再通率及支架內血管狹窄率與未破裂動脈瘤結果相近。但是，破裂動脈瘤患者髮生不良預後較為常見，手術相關併髮癥有較未破裂動脈瘤患者高的傾嚮，因此仍需慎用。
목적：탐토로내파렬관경동맥류급성기지가보조전새치료적유효성화안전성。방법회고련속납입178례환자192개관경동맥류，대비분석지가보조전새관경파렬화미파렬동맥류적료효。결과파렬동맥류78개，미파렬동맥류114개，지가식입성공솔100%，파렬동맥류조여미파렬동맥류조수술상관병발증분별14.1%화6.1%（χ2=3.456，P＞0.05），사망화영구치잔발생솔분별8.9%화6.1%（χ2=0.475，P＞0.05），차이무통계학의의。출원시파렬동맥류환자발생불량예후명현교미파렬동맥류환자상견（23.1%vs.5%，χ2=12.726，P＜0.001）。평균수방14.7개월，뇌혈관조영복사파렬동맥류조화미파렬동맥류조동맥류완전폐새솔분별74.1%화70.6%（χ2=0.197，P＞0.05）；동맥류복발솔분별10.3%화9.4%（χ2=0.034，P＞0.05）；지가내혈관협착발생솔분별3.4%화4.7%（χ2=0.136，P＞0.05）；차이무통계학의의。결론파렬관경동맥류급성기지가보조전새치료，장기수방동맥류완전폐새솔、동맥류재통솔급지가내혈관협착솔여미파렬동맥류결과상근。단시，파렬동맥류환자발생불량예후교위상견，수술상관병발증유교미파렬동맥류환자고적경향，인차잉수신용。
Objective To assess the safety and efficacy of stent-assisted coil embolization for acutely ruptured wide-necked intracranial aneurysms. Methods We retrospectively reviewed 192 wide-necked intracranial aneurysms in 178 patients. The efficacy and peri-procedure complications of stent-assisted embolization were compared between rup?ture aneurysms and unrupture aneurysms. Results Stent was successfully implanted in 78 rupture aneurysms and 114 un?rupture aneurysms. There was statistically significant difference between rupture aneurysms and unrupture aneurysms groups in rate of poor prognosis on discharge ( 23.1%vs. 5%,χ2=12.726, P<0.001) but not in the peri-procedure compli?cations rate (14.1%vs. 6.1%,χ2=3.456,P>0.05)nor in the rate of mortality and permanent disability (8.9%vs. 6.1%,χ2=0.475, P>0.05). Angiograms at 14.7 months of follow-up did not reveal any significant difference between rupture aneu?rysms and unrupture aneurysms groups in aneurysm complete occlusion (74.1%vs. 70.6%,χ2=0.197,P>0.05), recana?lization (10.3%vs. 9.4%,χ2=0.034,P>0.05)and in-stent stenosis (3.4%vs. 4.7%,χ2=0.136,P>0.05). Conclusion Stent-assisted coil embolization for acutely rupture wide-necked intracranial aneurysms can prevent recurrence effective?ly and can achieve high complete occlusion rate in long term follow-up. However, its procedure related complications and mortality is higher in rupture aneurysms than in unrupture aneurysms, which indicates that a caution is needed to conduct stent-assisted coil embolization in rupture aneurysms.
