Willis覆膜支架治疗颅内段颈内动脉病变临床应用

发布时间：2018-03-19 23:23

本文选题：Willis覆膜支架　切入点：颅内段颈内动脉病变　出处：《介入放射学杂志》2016年03期 　论文类型：期刊论文

【摘要】：目的评价Willis覆膜支架治疗颅内段颈内动脉病变的效果。方法回顾性分析2013年4月至2015年4月采用Willis覆膜支架治疗的201例颅内段颈内动脉病变患者。术后3~6个月随访复查DSA和临床观察结果。结果 Willis覆膜支架成功治疗198例颅内段颈内动脉病变,其中囊性动脉瘤88例,外伤性动脉瘤19例,假性动脉瘤35例,外伤性颈动脉海绵窦瘘56例,技术成功率达到98.5%。Willis覆膜支架释放部位依次为颈内动脉C7段9例,C6段28例,C5段32例,C4段110例,C3段19例;支架释放后即刻DSA显示病变完全不显影163例,内漏35例,经球囊后扩或再植入支架治疗后病变完全不显影33例(其中2例闭塞载瘤动脉),2例仍存在内漏。术中发生支架源性血管破裂出血5例,术中成功止血4例;术后再出血1例,死亡2例。术后3~6个月随访复查DSA显示载瘤动脉通畅189例,轻度狭窄5例;病变完全不显影196例。临床随访3~20个月,存活患者无新发神经系统体征。结论 Willis覆膜支架能够安全有效地治疗颅内段颈内动脉病变,但需要更远期随访。
[Abstract]:Objective to evaluate the effect of Willis stent implantation in the treatment of intracranial internal carotid artery disease. Methods from April 2013 to April 2015, 201 patients with intracranial internal carotid artery disease treated with Willis covered stent were analyzed retrospectively. Results Willis stent was successfully used in the treatment of 198 cases of intracranial internal carotid artery disease. There were 88 cases of cystic aneurysm, 19 cases of traumatic aneurysm, 35 cases of pseudoaneurysm and 56 cases of traumatic carotid cavernous fistula. The technical success rate was 98.5%. Willis stent release site was 9 cases of C7 segment of internal carotid artery and 28 cases of C 6 segment 28 cases of C 5 segment 32 cases of C 5 segment and 110 cases of C 4 segment C 3 segment 19 cases of C 3 segment, DSA showed no lesion in 163 cases and internal leakage in 35 cases immediately after stent release. 33 cases (including 2 cases with occlusive aneurysm and 2 cases with internal leakage) were treated with balloon dilatation or re-implantation of stenting stent, 5 cases with stent-derived vascular rupture, 4 cases with successful hemostasis, and 1 case with postoperative rebleeding. 2 cases died. DSA showed that the aneurysm was patency in 189 cases, slight stenosis in 5 cases, complete absence of lesion in 196 cases, and clinical follow-up for 3 ~ 20 months. Conclusion Willis covered stent is safe and effective in the treatment of intracranial internal carotid artery disease, but it needs more long-term follow-up.
【作者单位】：苏州大学医学部;上海交通大学附属第六人民医院介入影像科;
【基金】：国家自然科学基金(81201199)
【分类号】：R743

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