南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (03): 423-426.doi: 10.12122/j.issn.1673-4254.2020.03.23

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Solitaire 支架与lvis支架辅助弹簧圈栓塞对颅内宽颈动脉瘤的疗效对比

刘远来,孙异春,何永超,彭爱萍,于志虎,林其炎,张晓峰   

  • 出版日期:2020-04-08 发布日期:2020-03-20
  • 基金资助:

Treatment efficacy of Solitaire stent- and LVIS stent-assisted coil embolization for intracranial wide-neck carotid aneurysm

  

  • Online:2020-04-08 Published:2020-03-20

摘要: 目的 比较Lvis支架辅助弹簧圈和Solitaire支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤的安全性、有效性及其效果。方法 对2016年6月~2019年6月于南方医科大学附属小榄医院86例颅内宽颈动脉瘤患者为研究对象,为回顾性研究,将所有患者按随机数表法分为 A、B 两组,43例/组。A 组患者接受Lvis支架辅助弹簧圈填塞治疗,B 组患者接受Solitaire支架辅助弹簧圈栓塞治疗。于患者术中、术后即时和术后 3月进行动脉造影,分析对比两组间的即刻栓塞率、手术并发症(血管痉挛、急性血栓、弹簧圈逃逸、出血)及复发率。结果 LVIS支架组动脉瘤完全栓塞37个,近全栓塞5个,部分栓塞1个。Solitaire 支架组动脉瘤完全栓塞35个,近全栓塞6个,部分栓塞2个。LVIS支架组有5例,患者发生手术相关并发症,Solitaire支架组4例。术后3个月行数字减影血管造影(DSA)随访,4个动脉瘤出现了复发,其中LVIS组1例,Solitaire支架组有3例。所有随访患者预后良好,A、B两组差异无统计学意义(P>0.05)。结论 支架辅助弹簧圈治疗颅内动脉瘤完全和近全栓塞率较高,神经并发症发生率较低,预后较好。LVIS支架组与Solitaire支架组比较,栓塞率、并发症及复发率差异无统计学意义。

Abstract: Objective To compare the safety, efficacy and complications of LVIS stent- assisted coil embolization and Solitaire stent- assisted coil embolization for management of intracranial wide-neck carotid aneurysms. Methods We retrospectively analyzed the data of 86 patients with intracranial wide-neck carotid aneurysm treated in our hospital between June, 2016 and June, 2019. Forty- three of the patients received LVIS stent- assisted coil tamponade and the other 43 received Solitaire stentassisted coil tamponade. Arteriography was performed during, immediately after, and at 3 months after the surgery. The immediate embolization rate, surgical complications (vascular spasm, acute thrombus, coil escape, and bleeding), and the recurrence rate were compared between the two groups. Results In the LVIS stent group, 37 aneurysms were completely embolized, 5 were nearly fully embolized, and 1 was partially embolized, as compared with the numbers of 35, 6, and 2 in the Solitaire stent group, respectively. Surgery-related complications occurred in 5 patients in LVIS stent group and 3 in Solitaire stent group. Follow-up digital subtraction angiography (DSA) at 3 months after the operation revealed 4 recurrent aneurysms, including 1 in LVIS group and 3 in Solitaire stent group. All the patients had favorable outcomes that did not differ significantly between the two groups. Conclusion Stent-assisted spring coils can achieve a high rate of complete and near-total embolization for intracranial aneurysms and is associated with a low incidence of neurological complications and favorable prognosis of the patients. The embolization rate, complications and recurrence rate are comparable between LVIS stent and Solitaire stent.