摘要
目的 评估Tubridge血流导向装置（FD）治疗颅内前循环大型或巨大型动脉瘤的安全性及有效性.方法 回顾性收集与分析2010年8月-2012年8月应用Tubridge FD治疗的28例（共28个）颈内动脉囊状宽颈未破裂动脉瘤患者的临床资料及随访结果.结果 ①28个动脉瘤大小为11.3~44.0 mm,平均（21.6±7.1） mm.共置入Tubridge 支架 33枚,除1枚支架未能完全打开外,其余均成功置入目标位置.②28个动脉瘤中18个动脉瘤内填塞了弹簧圈,即刻栓塞结果按Raymond分级,瘤颈残留2例,大部栓塞16例;10个动脉瘤采取单纯FD治疗,置入FD后造影显示所有动脉瘤的对比剂充盈方式改变,瘤内对比剂滞留明显,其中7例术后瘤体充盈体积明显减少（5例充盈率减少为0~50%,2例充盈率减少≥50%）.治疗过程中,无一例发生操作相关出血性或缺血性事件.③临床随访过程中（6~30个月,平均19个月）,5例患者出现了短暂性的症状加重,13例患者症状缓解,6例改善,4例稳定.④术后25个动脉瘤获得DSA随访（5~24个月,平均9.9个月）,其中18例动脉瘤影像学治愈（72%）,6例改善（24%,仅为少量瘤颈残留）,1例稳定（4%）;支架覆盖的分支动脉均保持通畅,未发生支架内狭窄及载瘤动脉闭塞.结论 Tubridge FD治疗颅内前循环大型或巨大型动脉瘤是安全和有效的.但本组资料仅为单中心随访结果,长期疗效仍有待于前瞻性多中心的对照研究证实.
Objective To evaluate the safety and efficacy of Tubridge flow diverter （ FD ） in the treatment of large or giant intracranial anterior circulation aneurysms. Methods Twenty-eight patients treated with Tubridge FD from August 2010 to August 2012 were retrospectively collected and analyzed. The clinical data and follow-up results of 28 unruptured saccular wide-necked intraeranial aneurysms on the internal carotid arteries were obtained. Results ①The size of 28 aneurysms in this group was 11.3 - 44.0 mm （mean 21.6 ± 7.1 mm）. A total of 33 Tubridge FD were implanted. All the Tubridge FDs were successfully implanted except one failed to fully open.②Of the 28 aneurysms, 18 were packed with coils. The immediate embolization results were graded according to Raymond grade. Two patients had residual an- eurysm neck, 16 were mostly embolized; and 10 aneurysms were only treated with stents. After stenting, angiography showed that the filling mode of all aneurysmal contrast agents changed. Contrast agent retentionwithin the aneurysms was observed. Aneurysm filling volumes of 7 patients were significantly reduced after the procedure （ the reduced filling ratios in 5 patients were 0 to 50% and in 2 were 1〉 50% ）. During the treatment, no procedure-related hemorrhagic or ischemic events occurred in this group. ③In the clinical follow-up process （6 to 30 months, mean 19.0 months）, transient clinical symptoms aggravated in 5 pa- tients; at the last follow-up, the symptoms of 13 patients were relieved, 6 were improved, and 4 were sta- ble. ④ After the procedure, 25 aneurysms were followed up with DSA （5 to 24 months, mean 9. 9 months） , 18 of them were cured with aneurysm imaging （72%） , 6 were improved （24% , only a few re- sidual aneurysm necks）, and one was stable （4%） ; the branch arteries covered by stents still remained patent. No in-stent restenosis and parent artery occlusion occurred. Conclusion Tubridge FD is safe and effective in the treatment of large and giant intraeranial anterior circulation aneurysms. However, the data in this group is only the single center follow up results. The long term efficacy remains to be confirmed by a prospective muhicenter controlled study.
出处
《中国脑血管病杂志》
CAS
2013年第10期512-517,共6页
Chinese Journal of Cerebrovascular Diseases
基金
军队临床高新技术重大项目(2010gxjs058)
上海市科委重点项目(11DZ1921603)
关键词
颅内动脉瘤
血管内操作
随访研究
血流导向装置
大型或巨大型动脉瘤
Intracranial aneurysm
Endovascular procedures
Follow-up studies
Tubridge flowdiverter
Large or giant aneurysm
