目的探究血管内介入治疗颈内动脉眼动脉段动脉瘤的临床效果。方法选择济源市人民医院收治的31例颈内动脉眼动脉段动脉瘤患者,均实施血管内介入治疗,并依据肿瘤直径选择行单纯弹簧圈栓塞术或支架辅助弹簧圈栓塞术,观察术中情况,并随访12...目的探究血管内介入治疗颈内动脉眼动脉段动脉瘤的临床效果。方法选择济源市人民医院收治的31例颈内动脉眼动脉段动脉瘤患者,均实施血管内介入治疗,并依据肿瘤直径选择行单纯弹簧圈栓塞术或支架辅助弹簧圈栓塞术,观察术中情况,并随访12个月统计患者视力恢复、并发症、动脉瘤闭塞情况。结果 31例患者通过造影检查共发现36枚动脉瘤,其中瘤颈直径<2 mm 3枚,≥2 mm 33枚,视术中情况使用25枚支架,支架均成功释放至动脉瘤内,其中3枚出现支架移位,术中产生动脉瘤再次破裂出血1例,经及时发现并行栓塞治疗后无脑疝等并发症发生;经12个月随访,视力恢复正常者29例、视野缺损者1例、单纯偏盲者1例;动脉瘤完全闭塞30枚,大部分闭塞4枚,小部分闭塞2枚,且支架辅助弹簧圈栓塞术治疗者动脉瘤完全闭塞比例高于单纯弹簧圈栓塞术,差异具有统计学意义(P<0.05);动脉瘤复发1例,均为单纯弹簧圈栓塞术治疗者。结论对颈内动脉眼动脉段动脉瘤患者应用血管内介入治疗效果显著。展开更多
目的探讨经眶上外侧入路手术治疗颈内动脉眼动脉段动脉瘤的手术策略与疗效。方法回顾性分析24例颈内动脉眼动脉段动脉瘤病例资料,其中多发动脉瘤4例,共计28个动脉瘤。动脉瘤破裂致蛛网膜下腔出血12例。根据术前影像对动脉瘤进行分型:Ⅰ...目的探讨经眶上外侧入路手术治疗颈内动脉眼动脉段动脉瘤的手术策略与疗效。方法回顾性分析24例颈内动脉眼动脉段动脉瘤病例资料,其中多发动脉瘤4例,共计28个动脉瘤。动脉瘤破裂致蛛网膜下腔出血12例。根据术前影像对动脉瘤进行分型:Ⅰ型12例,Ⅱ型4例,Ⅲ型8例。均经眶上外侧入路手术治疗。结果动脉瘤直径≤5 mm 3个,>5~15 mm16个,>15~25 mm 7个,>25 mm 2个。夹闭23例,加固包裹1例。术后同侧视力下降与动眼神经麻痹2例,同侧视野偏盲1例。出院时GOS 5分22例,4分1例,3分1例(术前壳核出血)。Ⅰ、Ⅱ型病人与Ⅲ型病人术后脑神经功能损害,差异具有统计学意义(P=0.028)。结论经眶上外侧入路治疗颈内动脉眼动脉段动脉瘤显露良好,开颅过程简便,创伤小,术后效果好。经眶上外侧入路适用于大多数颈内动脉眼动脉段动脉瘤。展开更多
目的:探索药物洗脱球囊导管应用于症状性颈内动脉颅内段粥样硬化性狭窄中的安全性及有效性。方法:回顾性连续纳入2022年1月至2023年9月青岛大学附属医院神经介入科收治药物洗脱球囊导管治疗的45例症状性颈内动脉颅内段粥样硬化性狭窄患...目的:探索药物洗脱球囊导管应用于症状性颈内动脉颅内段粥样硬化性狭窄中的安全性及有效性。方法:回顾性连续纳入2022年1月至2023年9月青岛大学附属医院神经介入科收治药物洗脱球囊导管治疗的45例症状性颈内动脉颅内段粥样硬化性狭窄患者的临床资料,采用药物洗脱球囊对血管狭窄部位进行扩张治疗;药物球囊扩张前均先进行普通球囊进行预扩张。对患者围手术期并发症进行分析,并在术后的1个月、3个月和6个月进行临床随访。在术后6个月随访时,通过数字减影血管造影(Digital subtraction angiography, DSA)来评估患者靶病变血管的再狭窄状况。结果:45例患者顺利完成了药物洗脱球囊扩张手术,技术成功率100%。术中动脉夹层的发生率为26.7% (12/45),均接受了补救性支架的置入。围手术期有2例(4.4%)患者出现了症状性颅内出血,无死亡及缺血性脑卒中等并发症发生。45例患者完成随访,无失访患者,并在术后6个月随访时完成了DSA复查,共2例(4.4%)患者出现再狭窄。随访期间未发生相关责任区域相关的缺血性事件,无相关死亡发生;患者术前中位改良Rankin评分(Modified Rankin Scale, mRS) 1 (1, 2),术后1个月随访中位mRS评分为0 (0, 1),术后3个月及术后6个月随访中位mRS评分均为0 (0, 0),术后1个月,术后3个月、术后6个月mRS评分均低于术前,差异有统计学意义(P Objective: To explore the safety and efficacy of drug-coated balloon (DCB) angioplasty for patients with symptomatic intracranial internal carotid artery (ICA) atherosclerotic stenosis. Methods: From January 2022 to September 2023, a retrospective study consecutively enrolled 45 patients with severe atherosclerotic stenosis of the intracranial ICA who were managed with DCBs in the Department of Neurological Intervention, Affiliated Hospital of Qingdao University were retrospectively reviewed. The drug-coated balloon was used to dilate the stenotic vascular segments, with a regular balloon pre-dilation performed before the drug balloon expansion. Perioperative complications were analyzed, and clinical follow-ups were conducted at one, three, and six months post-surgery. At the six-month follow-up, digital subtraction angiography (DSA) was used to assess the restenosis status of the target lesion vessels. Results: Drug-coated balloon dilatation was successfully completed in 45 patients with a 100% technical success rate. The incidence of intraoperative arterial entrapment was 26.7% (12/45), all of whom received remedial stent placement. Symptomatic intracranial hemorrhage occurred in 2 (4.4%) patients during the perioperative period, and no complications such as death or ischemic stroke occurred. Follow-up was completed in 45 patients, with no patients lost to follow-up, and DSA review was completed at the 6-month postprocedural follow-up, with restenosis occurring in a total of 2 (4.4%) patients. There were no ischemic events related to the area of responsibility and no related deaths occurred during the follow-up period;patients had a median Modified Rankin Scale (mRS) of 1 (1, 2) preoperatively, a median mRS score of 0 (0, 1) at the 1-month postoperative follow-up visit, and a median mRS score of 0 (0, 0) at the 3-month postoperative and 6-month postoperative visits. The mRS scores at one, three, and six months post-surgery were all lower than the preoperative score, with statistically significant differences (P < 0.05). Conclusions: In patients with symptomatic atherosclerotic stenosis of the intracranial ICA, treatment with DCB dilatation has a high safety profile and improves the long-term prognosis of the patient.展开更多
目的探讨双LVIS支架辅助弹簧圈栓塞治疗颈内动脉床突上段破裂夹层动脉瘤(ruptured dissecting aneurysms of the supraclinoid internal carotid artery,RDA-SICA)的临床疗效和经验。方法回顾性分析12例采用双LVIS支架辅助弹簧圈栓塞治...目的探讨双LVIS支架辅助弹簧圈栓塞治疗颈内动脉床突上段破裂夹层动脉瘤(ruptured dissecting aneurysms of the supraclinoid internal carotid artery,RDA-SICA)的临床疗效和经验。方法回顾性分析12例采用双LVIS支架辅助弹簧圈栓塞治疗RDA-SICA患者的临床资料。结果术后造影显示Raymond分级Ⅰ级10例,Ⅱ级2例;其中1例术中动脉瘤破裂致少量出血,1例术后左侧颞叶迟发性出血,康复治疗后,无神经功能障碍。2例术后死于脑血管痉挛导致恶性脑水肿。存活10例患者,随访3~49个月,平均随访23.4个月,术后随访造影未见动脉瘤复发和支架内狭窄。结论双LVIS支架辅助弹簧圈栓塞治疗RDA-SICA是一种安全、有效的治疗方式,但仍需要多中心、大样本、长期随访的研究进一步证实。展开更多
文摘目的探究血管内介入治疗颈内动脉眼动脉段动脉瘤的临床效果。方法选择济源市人民医院收治的31例颈内动脉眼动脉段动脉瘤患者,均实施血管内介入治疗,并依据肿瘤直径选择行单纯弹簧圈栓塞术或支架辅助弹簧圈栓塞术,观察术中情况,并随访12个月统计患者视力恢复、并发症、动脉瘤闭塞情况。结果 31例患者通过造影检查共发现36枚动脉瘤,其中瘤颈直径<2 mm 3枚,≥2 mm 33枚,视术中情况使用25枚支架,支架均成功释放至动脉瘤内,其中3枚出现支架移位,术中产生动脉瘤再次破裂出血1例,经及时发现并行栓塞治疗后无脑疝等并发症发生;经12个月随访,视力恢复正常者29例、视野缺损者1例、单纯偏盲者1例;动脉瘤完全闭塞30枚,大部分闭塞4枚,小部分闭塞2枚,且支架辅助弹簧圈栓塞术治疗者动脉瘤完全闭塞比例高于单纯弹簧圈栓塞术,差异具有统计学意义(P<0.05);动脉瘤复发1例,均为单纯弹簧圈栓塞术治疗者。结论对颈内动脉眼动脉段动脉瘤患者应用血管内介入治疗效果显著。
文摘目的探讨经眶上外侧入路手术治疗颈内动脉眼动脉段动脉瘤的手术策略与疗效。方法回顾性分析24例颈内动脉眼动脉段动脉瘤病例资料,其中多发动脉瘤4例,共计28个动脉瘤。动脉瘤破裂致蛛网膜下腔出血12例。根据术前影像对动脉瘤进行分型:Ⅰ型12例,Ⅱ型4例,Ⅲ型8例。均经眶上外侧入路手术治疗。结果动脉瘤直径≤5 mm 3个,>5~15 mm16个,>15~25 mm 7个,>25 mm 2个。夹闭23例,加固包裹1例。术后同侧视力下降与动眼神经麻痹2例,同侧视野偏盲1例。出院时GOS 5分22例,4分1例,3分1例(术前壳核出血)。Ⅰ、Ⅱ型病人与Ⅲ型病人术后脑神经功能损害,差异具有统计学意义(P=0.028)。结论经眶上外侧入路治疗颈内动脉眼动脉段动脉瘤显露良好,开颅过程简便,创伤小,术后效果好。经眶上外侧入路适用于大多数颈内动脉眼动脉段动脉瘤。
文摘目的:探索药物洗脱球囊导管应用于症状性颈内动脉颅内段粥样硬化性狭窄中的安全性及有效性。方法:回顾性连续纳入2022年1月至2023年9月青岛大学附属医院神经介入科收治药物洗脱球囊导管治疗的45例症状性颈内动脉颅内段粥样硬化性狭窄患者的临床资料,采用药物洗脱球囊对血管狭窄部位进行扩张治疗;药物球囊扩张前均先进行普通球囊进行预扩张。对患者围手术期并发症进行分析,并在术后的1个月、3个月和6个月进行临床随访。在术后6个月随访时,通过数字减影血管造影(Digital subtraction angiography, DSA)来评估患者靶病变血管的再狭窄状况。结果:45例患者顺利完成了药物洗脱球囊扩张手术,技术成功率100%。术中动脉夹层的发生率为26.7% (12/45),均接受了补救性支架的置入。围手术期有2例(4.4%)患者出现了症状性颅内出血,无死亡及缺血性脑卒中等并发症发生。45例患者完成随访,无失访患者,并在术后6个月随访时完成了DSA复查,共2例(4.4%)患者出现再狭窄。随访期间未发生相关责任区域相关的缺血性事件,无相关死亡发生;患者术前中位改良Rankin评分(Modified Rankin Scale, mRS) 1 (1, 2),术后1个月随访中位mRS评分为0 (0, 1),术后3个月及术后6个月随访中位mRS评分均为0 (0, 0),术后1个月,术后3个月、术后6个月mRS评分均低于术前,差异有统计学意义(P Objective: To explore the safety and efficacy of drug-coated balloon (DCB) angioplasty for patients with symptomatic intracranial internal carotid artery (ICA) atherosclerotic stenosis. Methods: From January 2022 to September 2023, a retrospective study consecutively enrolled 45 patients with severe atherosclerotic stenosis of the intracranial ICA who were managed with DCBs in the Department of Neurological Intervention, Affiliated Hospital of Qingdao University were retrospectively reviewed. The drug-coated balloon was used to dilate the stenotic vascular segments, with a regular balloon pre-dilation performed before the drug balloon expansion. Perioperative complications were analyzed, and clinical follow-ups were conducted at one, three, and six months post-surgery. At the six-month follow-up, digital subtraction angiography (DSA) was used to assess the restenosis status of the target lesion vessels. Results: Drug-coated balloon dilatation was successfully completed in 45 patients with a 100% technical success rate. The incidence of intraoperative arterial entrapment was 26.7% (12/45), all of whom received remedial stent placement. Symptomatic intracranial hemorrhage occurred in 2 (4.4%) patients during the perioperative period, and no complications such as death or ischemic stroke occurred. Follow-up was completed in 45 patients, with no patients lost to follow-up, and DSA review was completed at the 6-month postprocedural follow-up, with restenosis occurring in a total of 2 (4.4%) patients. There were no ischemic events related to the area of responsibility and no related deaths occurred during the follow-up period;patients had a median Modified Rankin Scale (mRS) of 1 (1, 2) preoperatively, a median mRS score of 0 (0, 1) at the 1-month postoperative follow-up visit, and a median mRS score of 0 (0, 0) at the 3-month postoperative and 6-month postoperative visits. The mRS scores at one, three, and six months post-surgery were all lower than the preoperative score, with statistically significant differences (P < 0.05). Conclusions: In patients with symptomatic atherosclerotic stenosis of the intracranial ICA, treatment with DCB dilatation has a high safety profile and improves the long-term prognosis of the patient.
文摘目的探讨双LVIS支架辅助弹簧圈栓塞治疗颈内动脉床突上段破裂夹层动脉瘤(ruptured dissecting aneurysms of the supraclinoid internal carotid artery,RDA-SICA)的临床疗效和经验。方法回顾性分析12例采用双LVIS支架辅助弹簧圈栓塞治疗RDA-SICA患者的临床资料。结果术后造影显示Raymond分级Ⅰ级10例,Ⅱ级2例;其中1例术中动脉瘤破裂致少量出血,1例术后左侧颞叶迟发性出血,康复治疗后,无神经功能障碍。2例术后死于脑血管痉挛导致恶性脑水肿。存活10例患者,随访3~49个月,平均随访23.4个月,术后随访造影未见动脉瘤复发和支架内狭窄。结论双LVIS支架辅助弹簧圈栓塞治疗RDA-SICA是一种安全、有效的治疗方式,但仍需要多中心、大样本、长期随访的研究进一步证实。
