Department of Neurosurgery, Juntendo University, Faculty of Medicine, Japan.
Department of Neurosurgery, Juntendo University, Faculty of Medicine, Japan.
J Clin Neurosci. 2020 Oct;80:87-91. doi: 10.1016/j.jocn.2020.07.070. Epub 2020 Aug 17.
Authors reported the anatomical and clinical results of the stent assisted coiling (SAC) of unruptured middle cerebral artery (MCA) aneurysms using Low-profile Visualized Intraluminal Support Junior (LVIS Jr.). Forty-seven MCA aneurysms in 46 patients were the subjects of this study. The mean aneurysm size, neck width were 4.5 ± 1.8 mm, 3.0 ± 1.0 mm, respectively. Immediate anatomical outcomes were class Ⅰ in 31 (65.0%), class Ⅱ in 5 (10.6%) and class III in 11 (23.4%) patients according to Raymond-Roy classification. The latest anatomical outcomes were class Ⅰ in 33 (86.8%), class Ⅱ in 2 (5.3%) and class III in 3 (7.9%) patients. The change of aneurysm obliteration status were unchanged in 27 (71.0%), improved in 9 (23.7%) and worsen in 2 (5.3%). There were no recurrence necessitating additional treatment. Two patients suffered from angiographically evident in-stent thrombosis, but their clinical outcomes remain good. The modified Rankin scale at discharge were 0 in 45 patients, 1 in 1 patient. No patient showed clinical worsening during the clinical follow-up period at outpatient clinic (mean, 27.4 months). SAC of unruptured MCA aneurysms using LVIS Jr. provide safe and durable effect with high complete obliteration rate recurrence rate.
作者报告了使用 Low-profile Visualized Intraluminal Support Junior(LVIS Jr.)支架辅助弹簧圈栓塞(SAC)未破裂大脑中动脉(MCA)动脉瘤的解剖和临床结果。本研究共纳入 46 例患者的 47 个 MCA 动脉瘤。平均动脉瘤大小、瘤颈宽度分别为 4.5±1.8mm、3.0±1.0mm。根据 Raymond-Roy 分类,即刻解剖学结果为Ⅰ级 31 例(65.0%),Ⅱ级 5 例(10.6%),Ⅲ级 11 例(23.4%)。最新的解剖学结果为Ⅰ级 33 例(86.8%),Ⅱ级 2 例(5.3%),Ⅲ级 3 例(7.9%)。动脉瘤闭塞状态无变化 27 例(71.0%),改善 9 例(23.7%),恶化 2 例(5.3%)。无需要额外治疗的复发。2 例患者发生影像学证实的支架内血栓形成,但临床结局良好。出院时改良 Rankin 量表评分为 0 分 45 例,1 分 1 例。在门诊随访期间(平均 27.4 个月),无患者出现临床恶化。使用 LVIS Jr. 对未破裂 MCA 动脉瘤进行 SAC 可获得安全且持久的效果,完全闭塞率高,复发率低。