Gao X, Liang G, Li Z, Qu H, Wei X
Department of Neurosurgery, The General Hospital of Shenyang Military Command, Shenyang, China.
Interv Neuroradiol. 2010 Dec;16(4):385-93. doi: 10.1177/159101991001600404. Epub 2010 Dec 17.
We describe a modified stent-assisted coiling technique, named the semi-deployment technique, in the endovascular treatment of wide-neck aneurysms. Thirty-one consecutive patients with 31 wide-necked or fusiform intracranial aneurysms were treated with the semi-deployment technique. The technical feasibility of the procedure, procedure-related complications, angiographic results, clinical outcome and follow-up angiography were evaluated. In every case, the semi-deployment technique was successfully deployed. Immediate angiography demonstrated complete occlusion in 24 cases (77.4%), neck remnant in four cases (12.9%), and incomplete occlusion in three cases (9.7%). Procedural-related morbidity occurred in one patient (3.2%) but no procedural-related mortality. A favorable clinical outcome (Modified Ran-kin Scale score 0-2) was observed in 90.3% of the patients (average follow-up time, 23.1 months). No rehemorrhage of treated aneurysms occurred. Angiography follow-up was obtained in 22 cases (71.0 %). Three aneurysms (13.6 % of the follow-up angiograms) demonstrated recanalization. No delayed coil or stent migration was found. One patient had in-stent stenosis as a delayed complication. We found that the semi-deployment technique was helpful in the treatment of wide-neck aneurysms.
我们描述了一种改良的支架辅助弹簧圈栓塞技术,即半释放技术,用于宽颈动脉瘤的血管内治疗。连续31例患有31个宽颈或梭形颅内动脉瘤的患者接受了半释放技术治疗。评估了该手术的技术可行性、与手术相关的并发症、血管造影结果、临床结局及随访血管造影情况。在每例患者中,半释放技术均成功实施。即刻血管造影显示24例(77.4%)完全闭塞,4例(12.9%)瘤颈残留,3例(9.7%)不完全闭塞。1例患者(3.2%)发生与手术相关的并发症,但无手术相关死亡。90.3%的患者获得良好的临床结局(改良Rankin量表评分0 - 2)(平均随访时间23.1个月)。治疗的动脉瘤未发生再出血。22例(71.0%)患者获得血管造影随访。3个动脉瘤(占随访血管造影的13.6%)显示再通。未发现弹簧圈或支架延迟移位。1例患者发生支架内狭窄这一延迟并发症。我们发现半释放技术有助于宽颈动脉瘤的治疗。