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Neuroform 支架辅助弹簧圈栓塞术:一种治疗复杂颅内动脉瘤的新策略。中期随访结果。

Neuroform stent-assisted coil embolization: a new treatment strategy for complex intracranial aneurysms. Results of medium length follow-up.

机构信息

Department of Neurosurgery, First Affiliated Hospital, Sun Yatsen University, Guangzhou 510080, People's Republic of China.

出版信息

Neurol Neurochir Pol. 2010 Jul-Aug;44(4):366-74. doi: 10.1016/s0028-3843(14)60296-6.

Abstract

BACKGROUND AND PURPOSE

We present detailed results of using Neuroform stent-assisted coil embolization to treat complex cerebral aneurysms over a three-year period.

MATERIAL AND METHODS

Only patients who underwent Neuroform stent-assisted coil embolization were included in this study. We assessed patients' history, aneurysm morphology, indications for stenting, and technical details of the procedures, as well as complications and the midterm follow-up data.

RESULTS

This study included 26 patients with 39 aneurysms. A total of 32 of 39 aneurysms were treated by Neuroform stent-assisted embolization (SAC), whereas 3 aneurysms were stented without coiling, 2 aneurysms coiled without stenting and 2 aneurysms surgically clipped. The indications for use of stent included broad-neck aneurysms (n = 28), giant or large aneurysms (n = 6), and fusiform aneurysms (n = 5). Of the 32 aneurysms treated with Neuroform SAC, we achieved complete (100%) and near complete (> 95%) occlusion in 27 aneurysms, and partial (< 95%) occlusion in 5 aneurysms. Follow-up angiographic data available in 22 of 32 aneurysms treated with Neuroform SAC (68.7%) demonstrated recanalization in 3 aneurysms (13.6%), and stable occlusion in 19 aneurysms (86.4%). There was no delayed progressive embolization or in-stent stenosis.

CONCLUSIONS

Direct and midterm follow-up results confirmed that Neuroform stent-assisted coil embolization was a safe and effective technique in the treatment of complex cerebral aneurysms. Although clinically significant complications were uncommon and the evaluation at midterm follow-up is encouraging, further studies need to assess the long-term stability and durability of the stent.

摘要

背景与目的

我们呈现了三年内使用 Neuroform 支架辅助弹簧圈栓塞治疗复杂脑动脉瘤的详细结果。

材料与方法

本研究仅纳入接受 Neuroform 支架辅助弹簧圈栓塞的患者。我们评估了患者的病史、动脉瘤形态、支架置入指征以及手术技术细节,还评估了并发症和中期随访数据。

结果

本研究纳入了 26 例 39 个动脉瘤患者。39 个动脉瘤中,共有 32 个接受了 Neuroform 支架辅助栓塞(SAC)治疗,3 个未行弹簧圈栓塞而单纯支架置入,2 个未行支架置入而单纯弹簧圈栓塞,2 个动脉瘤行手术夹闭。支架置入指征包括宽颈动脉瘤(n = 28)、巨大或大型动脉瘤(n = 6)和梭形动脉瘤(n = 5)。32 个接受 Neuroform SAC 治疗的动脉瘤中,27 个达到了完全(100%)和近完全(>95%)闭塞,5 个达到了部分(<95%)闭塞。22 个接受 Neuroform SAC 治疗的动脉瘤中有 22 个(68.7%)可获得随访血管造影数据,其中 3 个(13.6%)出现再通,19 个(86.4%)稳定闭塞。无迟发性进展性栓塞或支架内狭窄。

结论

直接和中期随访结果证实,Neuroform 支架辅助弹簧圈栓塞治疗复杂脑动脉瘤是一种安全有效的技术。尽管临床显著并发症并不常见,中期随访评估结果令人鼓舞,但仍需要进一步研究评估支架的长期稳定性和耐久性。

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