Sedat Jacques, Chau Yves, Mondot Lydiane, Vargas Julian, Szapiro Jacek, Lonjon Michel
Unité de Neurointerventionnelle, Hôpital St. Roch, CHU Nice, 5 rue Pierre Devoluy, Nice, 06000, France.
Neuroradiology. 2009 Jun;51(6):401-9. doi: 10.1007/s00234-009-0502-2. Epub 2009 Feb 25.
Coiling associated with placement of self-expandable intracranial stents has amplified the treatment of intracranial wide-necked aneurysms, but the durability of this treatment and the existence of delayed recurrence are not yet well known. The purpose of this report is to present our experience with the Neuroform Stent associated with coiling and to evaluate complications, effectiveness, and long-term results of this technique.
A retrospective study of 42 patients with wide-necked cerebral aneurysms treated with the Neuroform Stent was performed. Mean aneurysm size was 11.3 mm. Mean neck size was 5.33 mm. All patients were treated with coiling and stenting. Clinical and angiographic follow-up was available in 38 patients (90.5%). The overall follow-up time ranged from 6 months to 5 years (mean, 42 months), but most of the patients (92%) had a follow-up period superior to 1 year.
Successful deployment of 41 stents (97%) was obtained. Permanent procedural morbidity was observed in only one patient (2.4%). Long-term complete aneurysmal occlusion was obtained in 27 patients (71%). Aneurysmal regrowth was observed in four patients (9.5%) on the first control angiogram. After the first control angiogram, no delayed recanalization or regrowth was observed. During the follow-up period, there were no hemorrhagic events, no delayed thrombosis, and no stent displacement.
Our results demonstrate the effectiveness of the technique, a small rate of procedural complications, and long-term tolerance of the Neuroform Stent. Despite some evidence of early aneurysmal recurrence, long-term durability of stent-assisted aneurysm occlusion is stable after the first year.
与自膨式颅内支架置入相关的弹簧圈栓塞技术扩大了颅内宽颈动脉瘤的治疗范围，但这种治疗方法的耐久性以及延迟复发的情况尚不为人所知。本报告的目的是介绍我们使用Neuroform支架联合弹簧圈栓塞的经验，并评估该技术的并发症、有效性和长期效果。
对42例接受Neuroform支架治疗的宽颈脑动脉瘤患者进行回顾性研究。动脉瘤平均大小为11.3毫米。瘤颈平均大小为5.33毫米。所有患者均接受了弹簧圈栓塞和支架置入治疗。38例患者（90.5%）获得了临床和血管造影随访。总体随访时间为6个月至5年（平均42个月），但大多数患者（92%）的随访期超过1年。
成功置入41枚支架（97%）。仅1例患者（2.4%）出现永久性手术并发症。27例患者（71%）实现了长期完全动脉瘤闭塞。在首次对照血管造影中，4例患者（9.5%）出现动脉瘤再生长。首次对照血管造影后，未观察到延迟再通或再生长。在随访期间，未发生出血事件、延迟血栓形成和支架移位。
我们的结果证明了该技术的有效性、较低的手术并发症发生率以及Neuroform支架的长期耐受性。尽管有一些早期动脉瘤复发的证据，但支架辅助动脉瘤闭塞的长期耐久性在第一年之后是稳定的。
