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目的探讨使用Neuroform支架或球囊与瘤颈重塑技术辅助弹簧圈栓塞颅内宽颈动脉瘤的疗效。方法207例颅内宽颈动脉瘤中,129例采用Neuroform支架瘤颈重塑技术辅助弹簧圈栓塞,78例采用球囊瘤颈重塑技术辅助弹簧圈栓塞。术后3个月对预后进行改良Rankin量表评分。术后6～12个月复查脑血管造影。结果以Neuroform支架辅助弹簧圈栓塞的78例动脉瘤中,完全栓塞114例,次全栓塞12例,部分栓塞3例。球囊辅助弹簧圈栓塞的动脉瘤中,完全栓塞69例,次全栓塞9例。Neuroform支架辅助组、球囊辅助组的预后良好率分别为:77.2%(98/129)、78.2%(61/78);预后不良率分别为:22.8%(29/129)、20.5%(16/78);病死率分别为:1.6%(2/129)、1.3%(1/78)。术后46例患者接受脑血管造影随访,其中Neuroform支架辅助组32例,球囊辅助组14例。影像学随访46例患者中,13例再通,7例影像学好转,26例稳定。结论Neuroform支架或球囊瘤颈重塑辅助弹簧圈栓塞是治疗颅内宽颈动脉瘤的有效方法,但各有其优缺点,应根据宽颈动脉瘤的具体情况选择恰当的方法进行栓塞。
Objective To investigate the curative effect of embolization of intracranial wide-necked aneurysms with the help of coiled coil and neoplasm reconstruction with Neuroform stent. Methods A total of 207 patients with intracranial wide-necked aneurysms were enrolled in this study. 129 patients underwent nephrotic embolization with Neuroform scaffold neck reconstruction technique and 78 patients underwent balloon embolization with balloon neck reconstruction technique. Three months after surgery, the prognosis was modified Rankin scale score. Cerebral angiography was reviewed after 6 to 12 months. Results Among the 78 aneurysms embolized with the Neuroform stent-assisted coil, 114 were completely embolized, 12 were sub-total embolized and 3 were partially embolized. In the aneurysm embolized with balloon-assisted coil, 69 cases were completely embolized and 9 cases were sub-total embolized. The good prognosis of the Neuroform stent-assisted group and balloon-assisted group were 77.2% (98/129) and 78.2% (61/78), respectively. The poor prognosis rates were 22.8% (29/129) and 20.5% / 78). The case fatality rates were 1.6% (2/129) and 1.3% (1/78) respectively. Forty-six patients underwent cerebrovascular angiography after follow-up, of whom 32 were in the Neuroform stent-assisted group and 14 in the balloon-assisted group. Of the 46 patients followed up for imaging, 13 recanalized, 7 improved imaging, and 26 were stable. Conclusion Neuroform stent or balloon neck reconstruction assisted coil embolization is an effective method for the treatment of wide-necked intracranial aneurysms, but each has its own advantages and disadvantages, and should be based on the specific circumstances of wide-necked aneurysms choose the appropriate method of embolization.