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使用Leo baby支架治疗囊状宽颈颅内动脉瘤:基于156例的单中心经验。

Treatment of saccular wide-neck intracranial aneurysm using Leo baby stent: a single-center experience based on 156 cases.

作者信息

Tang Haishuang, Lu Zhiwen, Zeng Zhangwei, Li Sisi, Shang Chenghao, Zuo Qiao, Liu Jianmin, Huang Qinghai

机构信息

Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.

China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China.

出版信息

Neurosurg Rev. 2024 Dec 27;48(1):5. doi: 10.1007/s10143-024-03167-5.

Abstract

To describe the mid-term safety and efficacy of Leo baby stent applied in saccular wide-neck intracranial aneurysms (IAs). 151 patients harboring 156 IAs treated with Leo baby stent from March 2021 to October 2023 were enrolled for further analysis. Among 156 IAs, 142 cases (91.0%) received one single Leo baby stent deployment while 14 cases (9.0%) received dual stents deployment. Stent-assisted coiling strategy was applied in all cases and the success rate was 100%. Immediate IAs occlusion results showed that 48 cases (30.8%) obtained Raymond grade I, 39 cases (25.0%) obtained Raymond grade II and 69 cases (44.2%) obtained Raymond grade III. Perioperative complications occurred in 10 cases (6.4%). Overall morbidity rate was 3.5% and mortality rate was 0% during follow-up. Clinical follow-up was available in 141 patients (93.4%). 136 patients (96.5%) got favorable clinical prognosis (mRS score 0-2) while 5 patients (3.5%) were in a poor neurological condition (mRS score 3-6). Angiographic follow-up was available in 136 cases (87.2%). The results showed that Raymond grade I was obtained in 112 cases (82.4%), Raymond grade II was obtained in 11 cases (8.1%) and Raymond grade III was obtained in 13 cases (9.6%). 4 cases (2.9%) were confirmed with IAs recurrence and received retreatment. Asymptomatic in-stent stenosis was detected in 8 patients (5.9%). The results demonstrate that stent-assisted coiling using Leo baby stent with favorable IAs embolization rate and the low complication rate is a feasible way in treating complex IAs.

摘要

描述利奥婴儿支架应用于囊状宽颈颅内动脉瘤(IA)的中期安全性和有效性。纳入2021年3月至2023年10月期间接受利奥婴儿支架治疗的151例患有156个IA的患者进行进一步分析。在156个IA中,142例(91.0%)接受了单个利奥婴儿支架置入,14例(9.0%)接受了双支架置入。所有病例均采用支架辅助弹簧圈栓塞策略,成功率为100%。IA即刻闭塞结果显示,48例(30.8%)达到Raymond I级,39例(25.0%)达到Raymond II级,69例(44.2%)达到Raymond III级。围手术期并发症发生10例(6.4%)。随访期间总体发病率为3.5%,死亡率为0%。141例患者(93.4%)获得临床随访。136例患者(96.5%)临床预后良好(mRS评分0 - 2),5例患者(3.5%)神经功能状态较差(mRS评分3 - 6)。136例(87.2%)获得血管造影随访。结果显示,112例(82.4%)达到Raymond I级,11例(8.1%)达到Raymond II级,13例(9.6%)达到Raymond III级。4例(2.9%)确诊为IA复发并接受再次治疗。8例患者(5.9%)检测到无症状支架内狭窄。结果表明,使用利奥婴儿支架进行支架辅助弹簧圈栓塞,IA栓塞率良好且并发症发生率低,是治疗复杂IA的一种可行方法。

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