Katsaridis V, Papagiannaki C, Violaris C
Neurosurgical Department, Papanikolaou General Hospital, Thessaloniki, Greece.
AJNR Am J Neuroradiol. 2006 May;27(5):1123-8.
The Neuroform2 stent has been increasingly used in the stent-assisted coiling of wide-necked cerebral aneurysms, mostly after pretreatment with antiplatelet drugs. We retrospectively analyzed our results of stent-assisted coiling without pretreatment with antiplatelets.
We used 50 Neuroform2 stents in the treatment of 54 aneurysms without pretreatment with antiplatelets. Anticoagulation included intraprocedural heparin, nadroparin for 3 days, clopidogrel for 3 months, and aspirin for 6 months.
Forty-nine stents were successfully deployed, and 52 of 54 aneurysms coiled (51 totally occluded and 1 subtotally). There was only one case of intraprocedural thrombus formation that was easily treated with recombinant tissue plasminogen activator. No serious hemorrhagic complications occurred during the follow-up period, and all 18 patients whose aneurysms have been controlled with angiography were found to have patent stents without stenosis and no aneurysm recanalization. No aneurysm rebleeding has occurred.
We believe that stent-assisted coiling with the Neuroform2 stent is very effective and safe without pretreatment with antiplatelets in ruptured as well as in unruptured aneurysms.
Neuroform2支架已越来越多地用于宽颈脑动脉瘤的支架辅助弹簧圈栓塞术，大多是在抗血小板药物预处理之后。我们回顾性分析了未进行抗血小板预处理的支架辅助弹簧圈栓塞术的结果。
我们使用50个Neuroform2支架治疗54个未进行抗血小板预处理的动脉瘤。抗凝措施包括术中使用肝素、使用那屈肝素3天、使用氯吡格雷3个月以及使用阿司匹林6个月。
49个支架成功置入，54个动脉瘤中的52个进行了弹簧圈栓塞（51个完全闭塞，1个次全闭塞）。仅1例术中血栓形成，使用重组组织型纤溶酶原激活剂易于治疗。随访期间未发生严重出血并发症，血管造影显示动脉瘤得到控制的所有18例患者的支架均通畅，无狭窄且无动脉瘤再通。未发生动脉瘤再出血。
我们认为，使用Neuroform2支架进行支架辅助弹簧圈栓塞术在破裂和未破裂动脉瘤中不进行抗血小板预处理时非常有效且安全。
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