Jia J, Lv X, Liu A, Wu Z, Li Y
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, China.
Interv Neuroradiol. 2012 Dec;18(4):426-31. doi: 10.1177/159101991201800408. Epub 2012 Dec 3.
We evaluate and report our clinical and angiographic outcomes associated with stent-assisted coil embolization of wide-necked intracranial aneurysms using the Enterprise stent. One hundred sixty-nine patients diagnosed with 182 wide-necked intracranial aneurysms underwent placement of the Enterprise stent between April 2009 and October 2011. Demographic information, procedural data, procedure-related complications, angiographic results, and clinical outcomes were reviewed and evaluated. Stent deployment was successful in 166 out of 169 procedures (98.2%). Four patients had acute procedure-related complications, including th romboembolism in three patients and aneurysm perforation resulting in the death of one patient. Immediate angiographic results showed complete occlusion in 101 aneurysms (56.4%) and near-complete occlusion in 55 aneurysms (30.7%). Follow-up angiography was performed in 108 patients with 119 aneurysms at a mean of 8.1 months: complete occlusion was observed in 95 aneurysms (79.8%) and near-complete occlusion was found in 12 aneurysms (10.1%). Delayed intra-stent thromboses were observed in two patients, and asymptomatic in-stent stenosis was observed in one patient. Ten aneurysms (8.4%, 10/119) demonstrated recanalization, all of which were subsequently recoiled successfully. Clinical follow-up was obtained for 132 patients at a mean of 11.4 months, out of which 118 (89.4%) had favorable clinical outcomes as determined using a modified Rankin Scale (mRS) ≤ 1. The rates of procedure-related mortality and permanent morbidity were 0.6% (1/169) and 2.3%( 3/132), respectively. This study adds to the current body of evidence supporting the Enterprise stent as an effective and safe tool for the treatment of wide-necked intracranial aneurysms because it results in more complete occlusion and lower complication rates.
我们评估并报告了使用Enterprise支架对宽颈颅内动脉瘤进行支架辅助弹簧圈栓塞治疗的临床和血管造影结果。2009年4月至2011年10月期间，169例被诊断为182个宽颈颅内动脉瘤的患者接受了Enterprise支架置入术。对人口统计学信息、手术数据、手术相关并发症、血管造影结果和临床结果进行了回顾和评估。169例手术中有166例（98.2%）成功置入支架。4例患者出现急性手术相关并发症，包括3例患者发生血栓栓塞，1例患者因动脉瘤穿孔死亡。即刻血管造影结果显示，101个动脉瘤（56.4%）完全闭塞，55个动脉瘤（30.7%）接近完全闭塞。108例患有119个动脉瘤的患者接受了平均8.1个月的随访血管造影：95个动脉瘤（79.8%）观察到完全闭塞，12个动脉瘤（10.1%）观察到接近完全闭塞。2例患者出现延迟性支架内血栓形成，1例患者出现无症状支架内狭窄。10个动脉瘤（8.4%，10/119）出现再通，所有这些动脉瘤随后均成功再栓塞。对132例患者进行了平均11.4个月的临床随访，其中118例（89.4%）使用改良Rankin量表（mRS）≤1确定临床预后良好。手术相关死亡率和永久性致残率分别为0.6%（1/169）和2.3%（3/132）。这项研究增加了当前支持Enterprise支架作为治疗宽颈颅内动脉瘤有效且安全工具的证据，因为它能实现更完全的闭塞并降低并发症发生率。
