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使用低轮廓可视化腔内支撑(LVIS)装置对破裂的宽颈前交通动脉瘤进行血管内治疗。

Endovascular Treatment of Ruptured Wide-Necked Anterior Communicating Artery Aneurysms Using a Low-Profile Visualized Intraluminal Support (LVIS) Device.

作者信息

Xue Gaici, Liu Peng, Xu Fengfeng, Fang Yibin, Li Qiang, Hong Bo, Xu Yi, Liu Jianmin, Huang Qinghai

机构信息

Department of Neurosurgery, General Hospital of Southern Theatre Command of People's Liberation Army of China, Guangzhou, China.

Department of Neurosurgery, Changhai Hospital, Navy Medical University, Shanghai, China.

出版信息

Front Neurol. 2021 Jan 28;11:611875. doi: 10.3389/fneur.2020.611875. eCollection 2020.

Abstract

To evaluate the safety and efficacy of low-profile visualized intraluminal support (LVIS) stent-assisted coiling for the treatment of ruptured wide-necked anterior communicating artery (ACoA) aneurysms. The clinical and angiographic data of 31 acutely ruptured wide-necked ACoA aneurysms treated with LVIS stent-assisted coiling between January 2014 and December 2018 were retrospectively reviewed. All stents were successfully deployed. The immediate angiographic results were modified Raymond-Roy class I in 27 cases, modified Raymond-Roy class II in 2 cases, and modified Raymond-Roy class IIIa in 2 cases. Intraoperative thrombosis and postoperative aneurysmal rebleeding occurred in one case each. Two patients (6.5%) who were admitted due to poor clinical grade conditions died during hospital admission as a result of initial bleeding. Angiographic follow-up (mean: 12.9 months) was performed for 26 patients, the results of which demonstrated that 25 aneurysms were completely occluded and one was class II. The last clinical follow-up (mean: 25.3 months) outcomes demonstrated that 27 patients had favorable clinical outcomes and two had poor clinical outcomes. LVIS stent-assisted coiling for ruptured wide-necked ACoA aneurysms was safe and effective, with a relatively low rate of perioperative complications and a high rate of complete occlusion at follow-up.

摘要

评估低轮廓可视化腔内支撑(LVIS)支架辅助弹簧圈栓塞术治疗破裂性宽颈前交通动脉(ACoA)动脉瘤的安全性和有效性。回顾性分析2014年1月至2018年12月期间采用LVIS支架辅助弹簧圈栓塞术治疗的31例急性破裂性宽颈ACoA动脉瘤的临床和血管造影资料。所有支架均成功植入。即刻血管造影结果为改良Raymond-Roy I级27例,改良Raymond-Roy II级2例,改良Raymond-Roy IIIa级2例。术中血栓形成和术后动脉瘤再出血各发生1例。2例(6.5%)因临床分级差入院的患者在住院期间因初次出血死亡。对26例患者进行了血管造影随访(平均12.9个月),结果显示25个动脉瘤完全闭塞,1个为II级。末次临床随访(平均25.3个月)结果显示,27例患者临床结局良好,2例患者临床结局较差。LVIS支架辅助弹簧圈栓塞术治疗破裂性宽颈ACoA动脉瘤安全有效,围手术期并发症发生率相对较低,随访时完全闭塞率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e39/7876256/732642f69bae/fneur-11-611875-g0001.jpg

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