Liu Aihua, Peng Tangming, Qian Zenghui, Li Youxiang, Jiang Chuhan, Wu Zhongxue, Yang Xinjian
Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing Neurosurgical Institute, Beijing, China.
Department of Neurosurgery, The Affiliated Hospital of Luzhou Medical College, Luzhou, China.
J Neuroradiol. 2015 Oct;42(5):298-303. doi: 10.1016/j.neurad.2014.11.005. Epub 2015 Feb 10.
Accumulated experience and improvement of stents dedicated to intracranial use have significantly widened the applicability of stent-assisted coiling (SAC) to ruptured wide-necked aneurysms. This retrospective study was designed to evaluate the safety and efficacy of SAC using the Enterprise stent for ruptured wide-necked intracranial aneurysms during ultra-early subarachnoid hemorrhage.
We reviewed data from 59 consecutive patients with ruptured wide-necked aneurysms who had SAC using the Enterprise stent performed within 48hours of onset. Data collected and analyzed included: patient demographics; morphologic features of the aneurysm; treatment results and follow-up results. Clinical outcomes were evaluated by modified Rankin Scale (mRS).
In all 59 cases, SAC using the Enterprise stent was performed successfully, with no significant technical difficulties. Initial angiographic results were: complete occlusion in 38 cases; near occlusion in 17; and partial occlusion in four. Angiographic follow-up of 48 patients showed that 46 (95.8%) remained stable or improved, without regrowth, while regrowth was imaged in two patients. Medium-term clinical follow-up of 54 patients (mean, 26.9months) showed that 88.9% had a good outcome (mRS: 0 in 34; 1 in eight; and 2 in six), and 11.1% poor outcomes (mRS: 3 in four; and 4 in two).
Enterprise SAC is a safe and viable option for treatment of ruptured wide-necked aneurysms within 48hours of ictus.
颅内专用支架的经验积累和改进显著拓宽了支架辅助弹簧圈栓塞术（SAC）在破裂宽颈动脉瘤治疗中的应用范围。本回顾性研究旨在评估使用Enterprise支架行SAC治疗超早期蛛网膜下腔出血时破裂宽颈颅内动脉瘤的安全性和有效性。
我们回顾了连续59例破裂宽颈动脉瘤患者的数据，这些患者在发病48小时内接受了使用Enterprise支架的SAC治疗。收集并分析的数据包括：患者人口统计学资料；动脉瘤的形态学特征；治疗结果和随访结果。临床结局采用改良Rankin量表（mRS）进行评估。
全部59例患者均成功实施了使用Enterprise支架的SAC治疗，无明显技术困难。初始血管造影结果为：38例完全闭塞；17例接近闭塞；4例部分闭塞。48例患者的血管造影随访显示，46例（95.8%）病情稳定或改善，无复发，2例患者出现复发。54例患者（平均随访26.9个月）的中期临床随访显示，88.9%预后良好（mRS：0级34例；1级8例；2级6例），11.1%预后不良（mRS：3级4例；4级2例）。
对于发病48小时内的破裂宽颈动脉瘤，Enterprise支架辅助弹簧圈栓塞术是一种安全可行的治疗选择。
