Fan Yi-Mu, Yan Shi-Xin, Wang Shi-Bo, Yang Tian-Hao, Huang Ying, Gao Man
Department of Neurosurgery, Huanhu Hospital, Tianjin 300060, China.
Zhonghua Wai Ke Za Zhi. 2007 Feb 15;45(4):220-2.
To discuss the avail of balloon and stent-assisted Guglielmi detachable coil (GDC) placement in treatment of wide-necked cerebral aneurysm.
Eighty-seven patients with 92 wide-necked aneurysms undergone endovascular procedures using the balloon and stent-assisted remodeling technique. Respectively, appropriate Neuroform stents delivered with a 5 mm landing zone on either side of the aneurysm neck, the microcatheter entered through the interstice, aneurysms were embolized at one or several times. Two catheters were used in balloon-remodeling technique, balloon were inflated across the neck of the aneurysms after the microcatheter entering the aneurysms, then the GDC were used to embolize the aneurysms.
Thirty-one aneurysms were completely occluded, 3 subtotally (> 90%) and 1 incompletely (70% - 90%) occluded using stent-assisted technique, all carry arteries were unblocked, 3 patients with mild neurological dysfunction and no mortality. Fifty aneurysms were completely occluded and 4 incompletely occluded using balloon-assisted technique, 1 patients with mild neurological dysfunction and no mortality. Two aneurysms were completely occluded and 1 incompletely occluded using stent-assisted and balloon-assisted technique. The mean period of follow-up was 5.8 months. Rates of recanalization were 16.7% for stent-remodeling group and 12.5% for balloon-remodeling group.
The stent and balloon-assisted remodeling technique are safe and effective in treating wide-necked aneurysms. Balloon-remodeling technique has more security comparing with stents.
探讨球囊及支架辅助 Guglielmi 可解脱弹簧圈(GDC)置入术治疗宽颈脑动脉瘤的有效性。
87 例患者共 92 个宽颈动脉瘤接受血管内介入治疗,采用球囊及支架辅助重塑技术。分别将合适的 Neuroform 支架放置在动脉瘤颈两侧各 5mm 的着陆区,微导管通过间隙进入,动脉瘤分一次或多次进行栓塞。球囊重塑技术使用两根导管,微导管进入动脉瘤后,球囊跨动脉瘤颈充气,然后用 GDC 栓塞动脉瘤。
支架辅助技术治疗的动脉瘤中,31 个完全闭塞,3 个次全闭塞(>90%),1 个部分闭塞(70% - 90%),所有载瘤动脉均通畅,3 例患者出现轻度神经功能障碍,无死亡病例。球囊辅助技术治疗的动脉瘤中,50 个完全闭塞,4 个部分闭塞,1 例患者出现轻度神经功能障碍,无死亡病例。1 个动脉瘤采用支架辅助及球囊辅助技术联合治疗,完全闭塞 2 个,部分闭塞 1 个。平均随访时间为 5.8 个月。支架重塑组再通率为 16.7%,球囊重塑组为 12.5%。
支架及球囊辅助重塑技术治疗宽颈动脉瘤安全有效。与支架相比,球囊重塑技术安全性更高。