Navien导管在颅内动脉瘤栓塞术中的应用

发布时间：2018-06-13 23:09

本文选题：颅内动脉瘤 + 血管内治疗　；参考：《中国脑血管病杂志》2017年03期

【摘要】：目的探讨Navien导管在颅内动脉瘤栓塞术中的使用技术及效果。方法回顾性分析皖南医学院附属弋矶山医院神经外科于2016年3月至12月血管内治疗颅内动脉瘤中使用Navien导管的15例患者资料。所有患者颈内动脉颅外段严重迂曲,术中均使用同轴系统,观察Navien导管能否顺利到达目标血管位置,并运用单纯弹簧圈或支架辅助弹簧圈栓塞治疗相应部位颅内动脉瘤,即刻栓塞结果按Raymond分级评价,观察术中和术后并发症并进行影像学随访。结果 15例患者均为颈内动脉颅外段异常迂曲,Navien导管能顺利通过弯曲血管并能到达目标位置,对9例患者采用支架辅助弹簧圈栓塞,6例患者采用单纯弹簧圈栓塞,弹簧圈和支架的置入技术成功率100%,支架均准确释放到位,无移位。动脉瘤即刻栓塞Raymond分级显示,RaymondⅠ级15例。术中1例出现颈内动脉痉挛,予以罂粟碱后好转,其余无术中脑血管痉挛、血管夹层、支架内血栓形成以及术中动脉瘤破裂等并发症。术后对5例进行DSA随访3~6个月,动脉瘤未见复发、支架无狭窄及移位,无再出血和脑缺血。结论对于存在颈内动脉颅外段严重迂曲的患者,使用Navien导管能克服动脉迂曲等不利因素,顺利到达目标血管位置,使得颅内动脉瘤的栓塞治疗顺利完成。
[Abstract]:Objective to investigate the technique and effect of Navien catheter in the embolization of intracranial aneurysm. Methods a retrospective analysis of 15 patients with Navien catheter in the treatment of intracranial aneurysms from March 2016 to December in the Department of Neurosurgery, affiliated to Wangnan Medical College. A coaxial system was used to observe whether the Navien catheter could successfully reach the target vessel position, and the intracranial aneurysm was treated with a simple spring coil or a stent assisted coils. The immediate embolic results were evaluated by Raymond classification. The postoperative complications were observed and followed by image follow-up. The results of the 15 patients were all cranium of the internal carotid artery. In the outer segment, the Navien catheter was able to pass through the curved vessel and reach the target position successfully. 9 patients were embolized by the stent assisted coil, 6 cases were embolized by pure coil, the success rate of the implantation of the spring coil and the stent was 100%. The stent was accurately released and unshifted. The aneurysm immediately embolized Raymond classification, Raymo There were 15 cases of nd I. 1 cases had internal carotid spasm, improved after papaverine, and other complications such as vasospasm, vascular dissection, stent thrombosis and intraoperative aneurysm rupture. After the operation, 5 cases were followed up for 3~6 months with DSA, no recurrence of aneurysm, no stenosis and displacement, no rebleeding and cerebral ischemia. In patients with severe tortuosity in the external segment of the internal carotid artery, the use of Navien catheter can overcome the adverse factors such as arterial circuitous and so on, and successfully reach the target vessel position, which makes the embolization therapy of intracranial aneurysm complete successfully.
【作者单位】：皖南医学院附属弋矶山医院神经外科;
【分类号】：R651.12

【参考文献】