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用于治疗颅外颈内动脉瘤的裸金属支架:长期结果

Bare metal stents for treatment of extracranial internal carotid artery aneurysms: long-term results.

作者信息

Welleweerd Janna C, de Borst Gert Jan, de Groot Daphne, van Herwaarden Joost A, Lo Rob T H, Moll Frans L

机构信息

University Medical Center Utrecht, The Netherlands.

University Medical Center Utrecht, The Netherlands

出版信息

J Endovasc Ther. 2015 Feb;22(1):130-4. doi: 10.1177/1526602814566405.

Abstract

PURPOSE

To examine the long-term outcomes of bare metal stent placement for exclusion of extracranial internal carotid artery (ICA) aneurysms.

METHODS

From 2006 to 2011, 7 consecutive symptomatic patients (4 men; mean age 52 years) with surgically inaccessible extracranial ICA aneurysms were treated with a bare stent at a single center. Patients received clopidogrel for 3 months after the procedure and aspirin for life. Clinical follow-up with duplex ultrasound and/or computed tomographic angiography was performed at 3, 6, and 12 months and yearly thereafter.

RESULTS

All procedures were technically successful; no neurological complications occurred. After 6 months, there was complete thrombosis of the aneurysm in all except one case. In this asymptomatic patient, the residual active flow was successfully obliterated by additional coil embolization. Over a mean follow-up of 57 ± 22 months, all patients were alive and free of local or central neurological symptoms. All stents were patent, and thrombosis of the aneurysms was complete.

CONCLUSION

In this small series, treatment of extracranial ICA aneurysms with a bare stent seems technically feasible and safe. All treated extracranial ICA aneurysms were excluded by primary intervention or secondary coil embolization.

摘要

目的

探讨裸金属支架置入术治疗颅外颈内动脉(ICA)动脉瘤的长期疗效。

方法

2006年至2011年,在单一中心对7例连续的有症状患者(4例男性;平均年龄52岁)进行了裸支架治疗,这些患者的颅外ICA动脉瘤无法通过手术治疗。术后患者接受氯吡格雷治疗3个月,终身服用阿司匹林。在术后3、6和12个月以及此后每年进行双功超声和/或计算机断层血管造影的临床随访。

结果

所有手术在技术上均获成功;未发生神经并发症。6个月后,除1例患者外,所有患者的动脉瘤均完全血栓形成。在这名无症状患者中,通过额外的弹簧圈栓塞成功消除了残留的活性血流。在平均57±22个月的随访期内,所有患者均存活,无局部或中枢神经系统症状。所有支架均通畅,动脉瘤血栓形成完全。

结论

在这个小系列研究中,用裸支架治疗颅外ICA动脉瘤在技术上似乎是可行和安全的。所有接受治疗的颅外ICA动脉瘤均通过初次干预或二次弹簧圈栓塞得以排除。

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