LVIS支架辅助栓塞治疗颅内动脉瘤20例的临床分析

LVIS stent-assisted embolization for treating intracranial aneurysm: a clinical analysis of 20 cases

摘要:

目的 探讨LVIS支架辅助栓塞颅内动脉瘤的安全性及有效性。方法 选取应用LVIS支架辅助栓塞治疗20例患者的颅内动脉瘤20个。并对其临床资料、血管内治疗方法及效果进行回顾性分析，根据Raymond分级评价动脉瘤栓塞程度，改良Rankin量表（modified Rankin Scale，mRS）评估其预后效果。结果 所有患者支架释放满意。术后即刻造影见Raymond分级Ⅰ级栓塞15例（75%），Ⅱ级栓塞4例（20%），Ⅲ级栓塞1例（5%）。经术后3~12月随访的18个动脉瘤中，均未见复发，其中16个动脉瘤影像学治愈（88.9%），2个瘤颈残留但稳定（11.1%）。在访的18位患者中15位预后良好（mRS：0-2分）。结论 LVIS支架辅助弹簧圈栓塞安全可行，可提高动脉瘤的栓塞率和降低复发率，远期临床效果还有待大样本随访和临床经验的总结。

Abstract:

Objective To investigate the safety and efficacy of low-profile visualized intraluminal support (LVIS) stent-assisted embolization in the treatment of intracranial aneurysm.Methods A retrospective analysis was performed on the clinical data, endovascular treatment methods, and clinical outcome of 20 patients with 20 intracranial aneurysms who were treated with LVIS stent-assisted embolization. The degree of aneurysm embolization was evaluated according to the Raymond classification, and the clinical outcome was evaluated using the modified Rankin Scale (mRS).Results The stent release was satisfactory in all patients. Immediate postoperative angiography showed that Raymond grade I embolization was achieved in 15 patients (75%), Raymond grade II embolization in 4 patients (20%), and Raymond grade III embolization in 1 patient (5%). After 3-12 months of follow-up for 18 aneurysms, no recurrence was observed; the imaging results showed that 16 (88.9%) of the 18 aneurysms were cured and 2 (11.1%) remained stable. And 15 of the 18 patients had a good clinical outcome (mRS score 0-2).Conclusions LVIS stent-assisted coil embolization is safe and feasible. It can improve the embolization rate and reduce the recurrence rate of aneurysms. However, the long-term clinical effect needs to be confirmed by further studies with a large sample size and a summary of clinical experiences.