Pipeline血流导向装置治疗颅内复杂动脉瘤的短期疗效

发布时间：2018-04-09 01:40

本文选题：颅内复杂动脉瘤　切入点：Pipeline血流导向装置　出处：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨Pipeline血流导向装置(PED)治疗颅内复杂动脉瘤的短期疗效。方法:分析新疆医科大学第一附属医院神经外科自2015年4月至2016年10月应用PED治疗29例颅内复杂动脉瘤患者的临床资料,其中女22例,男7例;年龄在16—78岁之间(平均53.0±13.6)。29例患者共32个动脉瘤,颈内动脉海绵窦段6个,颈内动脉床突段18个,颈内动脉岩骨段1个,后交通动脉瘤3个,椎动脉1个,小脑后下动脉瘤3个。小型动脉瘤(瘤体3mm-10mm)3个,中大型动脉瘤(瘤体10mm-25mm)15个,巨大动脉瘤(瘤体大于25mm)8个,梭型动脉瘤5个,复发动脉瘤1个。结果:32个动脉瘤共治疗31个动脉,放置pipeline支架30枚,有1例应用2枚支架,其余均使用1枚支架。单纯PED植入10例,联合弹簧圈治疗19例,有2例在支架释放后进行球囊扩张。2例(6.9%)分别在术后2小时和5天出现蛛网膜下腔出血而死亡。有25例患者得到术后6个月随访,其中21例患者获得DSA随访,4例行头颅MRA随访。在17例随访患者中,有23例(92.0%)患者动脉瘤完全或几乎闭塞,动脉瘤不完全闭塞2例(8.0%)。结论:对于大型及巨大动脉瘤、宽颈动脉瘤、梭型动脉瘤等难治性复杂动脉瘤,PED提供了一种安全、有效的治疗方式,其动脉瘤闭塞率高、并发症发生率低。
[Abstract]:Objective: to investigate the short-term effect of Pipeline blood flow guide device (PED) in the treatment of complex intracranial aneurysms.Methods: the clinical data of 29 patients with complex intracranial aneurysms treated with PED from April 2015 to October 2016 in the first affiliated Hospital of Xinjiang Medical University were analyzed.There were 32 aneurysms, 6 cavernous sinus segments, 18 clinoid segments of internal carotid artery, 1 petrosal bone segment of internal carotid artery, 3 aneurysms of posterior communicating artery and 1 vertebral artery.3 aneurysms of posterior inferior cerebellar artery.There were 3 small aneurysms (3mm-10mm), 15 medium and large aneurysms (10mm-25mm), 8 giant aneurysms (larger than 25mm), 5 parenchymal aneurysms and 1 recurrent aneurysm.Results: 31 arteries were treated with 32 aneurysms, 30 pipeline stents were placed, 2 stents were used in 1 case, and 1 stent was used in the rest.Only 10 cases were implanted with PED and 19 cases were treated with coils. 2 cases underwent balloon dilatation after stent release. 2 cases died of subarachnoid hemorrhage 2 hours and 5 days after operation.Twenty-five patients were followed up 6 months after operation, 21 of them were followed up by DSA, 4 patients were followed up with cranial MRA.Of the 17 patients followed up, 23 had aneurysms completely or almost occluded and 2 had incomplete aneurysms.Conclusion: PED is a safe and effective treatment for large and large aneurysms, wide carotid aneurysms, fusiform aneurysms and other refractory complex aneurysms. The rate of aneurysm occlusion is high and the incidence of complications is low.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743

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