Zhang Tao, Deng Jianping, Chen Hu, Liu Yufeng, Wang Fangfang, Li Shuai, Liu Fude, Zhao Zhenwei
Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
Zhonghua Wai Ke Za Zhi. 2016 May 1;54(5):346-51. doi: 10.3760/cma.j.issn.0529-5815.2016.05.006.
To investigate the therapeutic effect of cranial-cervical aneurysms with stent-graft.
Clinical data of 20 patients with cranial-cervical aneurysm treated with stent-graft in Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University from November 2006 to November 2015 were retrospectively analyzed. There were 15 male and 5 female patients with a mean age of 40 years (ranging from 22 to 67 years). There were 10 spontaneous cases, 5 trauma history cases and 5 surgery history cases. Postoperative follow-up were made by telephone, CT angiography or digital subtraction angiography, evaluating therapeutic effect.
Twenty-four stent-grafts placement were carried out in 20 patients and all of them were successfully deployed in the parent artery. Intraoperative stent malapposition induced endoleak occurred in 3 cases, incomplete coverage of distal stent segment in 2 cases, acute thrombosis in 1 case and vessel lesion in 1 case. Eighteen cases were radiographically cured while the other 2 cases improved through additional stent placement, coil embolization or artery thrombolysis. Clinical symptoms of post-operative patients were improved to varying degrees. Follow-up of 1 to 96 months (average of 19 months) were accomplished. Delayed parent artery occlusion were encountered in 2 cases while endoleak still existed in 1 case.
Application of stent-graft for cranial-cervical aneurysms is safe and effective and the short-term follow-up results are satisfied.
探讨支架型血管治疗颅颈段动脉瘤的疗效。
回顾性分析2006年11月至2015年11月第四军医大学唐都医院神经外科收治的20例采用支架型血管治疗的颅颈段动脉瘤患者的临床资料。其中男性15例，女性5例，平均年龄40岁（22～67岁）。病因包括自发性动脉瘤10例，有外伤史5例，有手术史5例。术后通过电话、CT血管造影或数字减影血管造影进行随访，评估治疗效果。
20例患者共置入24枚支架型血管，均成功植入载瘤动脉。术中发生支架贴壁不良致内漏3例，支架远端覆盖不全2例，急性血栓形成1例，血管损伤1例。影像学治愈18例，另外2例经追加支架置入、弹簧圈栓塞或动脉溶栓后好转。术后患者临床症状均有不同程度改善。随访1～96个月（平均19个月），2例出现载瘤动脉延迟闭塞，1例仍存在内漏。
支架型血管治疗颅颈段动脉瘤安全有效，短期随访效果满意。
