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目的探讨Jostent冠状动脉覆膜支架对外伤性颈内动脉海绵窦瘘(TCCF)及难治性颅内动脉瘤的血管内治疗效果。方法自2003年10月至2009年10月四川大学华西医院神经外科应用Jostent冠状动脉覆膜支架治疗TCCF及难治性颅内动脉瘤35例,其中TCCF 15例,颈内动脉瘤11例,椎动脉瘤9例。结果 35例中33例一次性于靶动脉置入覆膜支架成功,动脉瘤(瘘)完全消除并保持载瘤动脉畅通,临床效果满意。1例TCCF及1例椎动脉夹层动脉瘤患者因血管迂曲,覆膜支架无法到达指定位置。三维数字减影血管造影随访17例,原动脉瘤(瘘)未见显示,载瘤动脉畅通。结论对于TCCF及难治性颅内动脉瘤,覆膜支架是有效的血管内治疗手段。
Objective To investigate the endovascular treatment of intracranial arterial fistula (TCCF) and refractory intracranial aneurysms by Jostent coronary stent. METHODS: From October 2003 to October 2009, 35 patients with TCCF and refractory intracranial aneurysm were treated with Jostent coronary stent in Department of Neurosurgery, West China Hospital of Sichuan University. Among them, 15 cases were TCCF, 11 cases were internal carotid aneurysm, Aneurysms in 9 cases. Results Of the 35 cases, 33 cases of stent-graft were successfully placed in the target artery. The aneurysm (fistula) was completely eliminated and the parent artery was kept open. The clinical effect was satisfactory. 1 case of TCCF and 1 case of vertebral artery aneurysm tortuous vessels, covered stent can not reach the designated location. Three-dimensional digital subtraction angiography followed-up of 17 cases, the original aneurysm (fistula) showed no, carrying artery unobstructed. Conclusion For TCCF and refractory intracranial aneurysms, stent-graft is an effective endovascular treatment.