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Willis覆膜支架治療顱內(nèi)段頸內(nèi)動脈病變臨床應(yīng)用

發(fā)布時間:2018-03-19 23:23

  本文選題:Willis覆膜支架 切入點(diǎn):顱內(nèi)段頸內(nèi)動脈病變 出處:《介入放射學(xué)雜志》2016年03期  論文類型:期刊論文


【摘要】:目的評價Willis覆膜支架治療顱內(nèi)段頸內(nèi)動脈病變的效果。方法回顧性分析2013年4月至2015年4月采用Willis覆膜支架治療的201例顱內(nèi)段頸內(nèi)動脈病變患者。術(shù)后3~6個月隨訪復(fù)查DSA和臨床觀察結(jié)果。結(jié)果 Willis覆膜支架成功治療198例顱內(nèi)段頸內(nèi)動脈病變,其中囊性動脈瘤88例,外傷性動脈瘤19例,假性動脈瘤35例,外傷性頸動脈海綿竇瘺56例,技術(shù)成功率達(dá)到98.5%。Willis覆膜支架釋放部位依次為頸內(nèi)動脈C7段9例,C6段28例,C5段32例,C4段110例,C3段19例;支架釋放后即刻DSA顯示病變完全不顯影163例,內(nèi)漏35例,經(jīng)球囊后擴(kuò)或再植入支架治療后病變完全不顯影33例(其中2例閉塞載瘤動脈),2例仍存在內(nèi)漏。術(shù)中發(fā)生支架源性血管破裂出血5例,術(shù)中成功止血4例;術(shù)后再出血1例,死亡2例。術(shù)后3~6個月隨訪復(fù)查DSA顯示載瘤動脈通暢189例,輕度狹窄5例;病變完全不顯影196例。臨床隨訪3~20個月,存活患者無新發(fā)神經(jīng)系統(tǒng)體征。結(jié)論 Willis覆膜支架能夠安全有效地治療顱內(nèi)段頸內(nèi)動脈病變,但需要更遠(yuǎn)期隨訪。
[Abstract]:Objective to evaluate the effect of Willis stent implantation in the treatment of intracranial internal carotid artery disease. Methods from April 2013 to April 2015, 201 patients with intracranial internal carotid artery disease treated with Willis covered stent were analyzed retrospectively. Results Willis stent was successfully used in the treatment of 198 cases of intracranial internal carotid artery disease. There were 88 cases of cystic aneurysm, 19 cases of traumatic aneurysm, 35 cases of pseudoaneurysm and 56 cases of traumatic carotid cavernous fistula. The technical success rate was 98.5%. Willis stent release site was 9 cases of C7 segment of internal carotid artery and 28 cases of C 6 segment 28 cases of C 5 segment 32 cases of C 5 segment and 110 cases of C 4 segment C 3 segment 19 cases of C 3 segment, DSA showed no lesion in 163 cases and internal leakage in 35 cases immediately after stent release. 33 cases (including 2 cases with occlusive aneurysm and 2 cases with internal leakage) were treated with balloon dilatation or re-implantation of stenting stent, 5 cases with stent-derived vascular rupture, 4 cases with successful hemostasis, and 1 case with postoperative rebleeding. 2 cases died. DSA showed that the aneurysm was patency in 189 cases, slight stenosis in 5 cases, complete absence of lesion in 196 cases, and clinical follow-up for 3 ~ 20 months. Conclusion Willis covered stent is safe and effective in the treatment of intracranial internal carotid artery disease, but it needs more long-term follow-up.
【作者單位】: 蘇州大學(xué)醫(yī)學(xué)部;上海交通大學(xué)附屬第六人民醫(yī)院介入影像科;
【基金】:國家自然科學(xué)基金(81201199)
【分類號】:R743

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