LVIS支架辅助弹簧圈栓塞颅内动脉瘤的相关回顾性研究
发布时间：2018-10-05 21:54
【摘要】：研究目的:通过观察LVIS(Low-profile visible intraluminal support device)支架辅助弹簧圈栓塞颅内动脉瘤,探讨LVIS支架辅助弹簧圈栓塞颅内动脉瘤的安全性、有效性及预后相关因素,为临床应用LVIS支架辅助弹簧圈治疗颅内动脉瘤提供理论依据。研究方法:选取2014年-2016年于山东省济宁市第一人民医院神经血管外科应用LVIS支架辅助弹簧圈介入栓塞治疗的颅内动脉瘤患者共54例,整理和收集所有治疗患者的一般资料(包括患者的发病年龄、性别、是否患有高血压病、动脉瘤的部位、术前的H-H分级)、影像学资料、围手术期并发症、治疗效果(动脉瘤栓塞程度)、随访资料(MRS预后评分和复发率),采用SPSS17.0统计软件对结果进行统计分析,评价LVIS支架辅助弹簧圈栓塞颅内动脉瘤的安全性和有效性及预后相关因素。研究结果:术后即刻栓塞程度用Raymond标准评估,58枚动脉瘤100%完全栓塞56枚,95%-99%次完全栓塞2枚,小于95%不完全栓塞0枚。宽颈和窄颈动脉瘤在即刻栓塞程度上无明显统计学差异(P0.05)。发生围手术期并发症7例,术中发生破裂出血2例,术中血栓形成1例,支架移位1例,脑积水3例。总体并发症发生率为13.0%。宽颈和窄颈动脉瘤围手术期并发症发生率无明显统计学差异(P0.05),患者有无高血压围手术期并发症发生率无明显统计学差异(P0.05)。Rankin改良预后评分(mRS评分)评价出院转归,0-2分级50例,3-6分4例。均经过3-12个月的随访,均经DSA复查,其中复发2例。有无高血压的患者预后及复发率之间无明显统计学差异(P0.05),宽颈和窄颈动脉瘤的预后及复发率之间无明显统计学差异(P0.05)。研究结论:LVIS支架辅助弹簧圈栓塞颅内动脉瘤是一种安全有效的治疗方法,LVIS支架适合颅内不同部位动脉瘤的辅助栓塞治疗,对各种类型动脉瘤都有很好的治疗效果。高血压对于LVIS支架辅助弹簧圈栓塞颅内动脉瘤的预后及复发无影响。LVIS支架辅助弹簧圈栓塞治疗颅内宽颈和窄颈动脉瘤的栓塞程度、并发症及复发比例无明显差异。
[Abstract]:Objective: to investigate the safety, efficacy and prognostic factors of LVIS (Low-profile visible intraluminal support device) stent assisted coils) for embolization of intracranial aneurysms. To provide a theoretical basis for the clinical application of LVIS stent assisted coils in the treatment of intracranial aneurysms. Methods: a total of 54 patients with intracranial aneurysms who were treated with LVIS stent-assisted coils in neurovascular surgery from 2014 to 2016 in the first people's Hospital of Jining, Shandong Province, were selected. Collate and collect general data of all patients (including age, sex, hypertension, location of aneurysm, H-H grade before operation), imaging data, perioperative complications, The results of treatment (degree of embolization of aneurysm), follow-up data (MRS prognosis score and recurrence rate) were analyzed by SPSS17.0 software to evaluate the safety, efficacy and prognostic factors of LVIS stent-assisted coils for embolization of intracranial aneurysms. Results: the degree of embolization in 58 aneurysms was evaluated by Raymond standard immediately after operation. 56 aneurysms were completely embolized by 100%, 56 aneurysms were completely embolized, 56 aneurysms were completely embolized by 95% embolization, 2 aneurysms were completely embolized, and 0 aneurysms were less than 95% incomplete embolization. There was no significant difference in the degree of immediate embolization between wide neck and narrow carotid aneurysms (P0.05). Perioperative complications occurred in 7 cases, rupture and hemorrhage in 2 cases, thrombosis in 1 case, stent displacement in 1 case, hydrocephalus in 3 cases. The overall incidence of complications was 13.0. There was no significant difference in the incidence of perioperative complications between wide neck aneurysms and narrow carotid aneurysms (P0.05). There was no significant difference in the incidence of perioperative complications in patients with hypertension (P0.05). Rankin improved prognosis score (mRS score) was used to evaluate the outcome of discharge. 50 cases were divided into 3-6 points and 4 cases were classified. All of them were followed up for 3-12 months, all of them were reexamined by DSA. There was no significant difference in prognosis and recurrence rate between patients with or without hypertension (P0.05), while there was no significant difference in prognosis and recurrence rate between wide neck and narrow carotid aneurysms (P0.05). Conclusion it is a safe and effective method to embolize intracranial aneurysms with the help of the: LVIS stent-assisted coils. LVIS stent is suitable for different parts of intracranial aneurysms and has a good therapeutic effect on various types of aneurysms. Hypertension had no effect on the prognosis and recurrence of embolization of intracranial aneurysms with LVIS stent-assisted coils. There was no significant difference in the degree of embolization of intracranial aneurysms with wide neck and narrow carotid aneurysms, and there was no significant difference in the rate of complications and recurrence.
【学位授予单位】：济宁医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12
本文编号：2255003
[Abstract]:Objective: to investigate the safety, efficacy and prognostic factors of LVIS (Low-profile visible intraluminal support device) stent assisted coils) for embolization of intracranial aneurysms. To provide a theoretical basis for the clinical application of LVIS stent assisted coils in the treatment of intracranial aneurysms. Methods: a total of 54 patients with intracranial aneurysms who were treated with LVIS stent-assisted coils in neurovascular surgery from 2014 to 2016 in the first people's Hospital of Jining, Shandong Province, were selected. Collate and collect general data of all patients (including age, sex, hypertension, location of aneurysm, H-H grade before operation), imaging data, perioperative complications, The results of treatment (degree of embolization of aneurysm), follow-up data (MRS prognosis score and recurrence rate) were analyzed by SPSS17.0 software to evaluate the safety, efficacy and prognostic factors of LVIS stent-assisted coils for embolization of intracranial aneurysms. Results: the degree of embolization in 58 aneurysms was evaluated by Raymond standard immediately after operation. 56 aneurysms were completely embolized by 100%, 56 aneurysms were completely embolized, 56 aneurysms were completely embolized by 95% embolization, 2 aneurysms were completely embolized, and 0 aneurysms were less than 95% incomplete embolization. There was no significant difference in the degree of immediate embolization between wide neck and narrow carotid aneurysms (P0.05). Perioperative complications occurred in 7 cases, rupture and hemorrhage in 2 cases, thrombosis in 1 case, stent displacement in 1 case, hydrocephalus in 3 cases. The overall incidence of complications was 13.0. There was no significant difference in the incidence of perioperative complications between wide neck aneurysms and narrow carotid aneurysms (P0.05). There was no significant difference in the incidence of perioperative complications in patients with hypertension (P0.05). Rankin improved prognosis score (mRS score) was used to evaluate the outcome of discharge. 50 cases were divided into 3-6 points and 4 cases were classified. All of them were followed up for 3-12 months, all of them were reexamined by DSA. There was no significant difference in prognosis and recurrence rate between patients with or without hypertension (P0.05), while there was no significant difference in prognosis and recurrence rate between wide neck and narrow carotid aneurysms (P0.05). Conclusion it is a safe and effective method to embolize intracranial aneurysms with the help of the: LVIS stent-assisted coils. LVIS stent is suitable for different parts of intracranial aneurysms and has a good therapeutic effect on various types of aneurysms. Hypertension had no effect on the prognosis and recurrence of embolization of intracranial aneurysms with LVIS stent-assisted coils. There was no significant difference in the degree of embolization of intracranial aneurysms with wide neck and narrow carotid aneurysms, and there was no significant difference in the rate of complications and recurrence.
【学位授予单位】：济宁医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12
【参考文献】
相关期刊论文 前10条
1 张明铭;欧阳奕安;黄昊;蒋宇钢;喻孟强;;LVIS支架在颅内微小动脉瘤中的应用[J];中南大学学报(医学版);2016年08期
2 许岗勤;李天晓;王子亮;薛绛宇;朱良付;白卫星;汪勇锋;;LVIS支架在辅助栓塞颅内宽颈微小动脉瘤中的应用[J];中华神经医学杂志;2016年08期
3 李立;李天晓;王子亮;白卫星;薛绛宇;朱良付;冯光;;LVIS支架辅助栓塞小型颅内动脉瘤的初步经验[J];中华神经外科杂志;2016年04期
4 纪文军;康慧斌;孙立倩;刘爱华;姜除寒;杨新健;李佑祥;吴中学;;Enterprise多支架重叠技术在未破裂椎动脉夹层动脉瘤中的应用[J];中国微侵袭神经外科杂志;2016年03期
5 胡骁;周林裕;王克;邓剑平;赵振伟;;支架辅助血管内栓塞前交通动脉破裂动脉瘤的疗效[J];中国临床神经外科杂志;2016年02期
6 张波;叶明;陈圣攀;张鹏;李萌;;Lvis支架在血管内治疗颅内宽颈动脉瘤中的应用[J];中华神经外科杂志;2015年10期
7 黄志伟;李学东;覃军;陆建吾;黄河清;;Solitaire AB支架辅助栓塞颅内动脉瘤临床随访研究[J];介入放射学杂志;2015年04期
8 伍杰;杨铭;李俊;潘力;陈刚;祝源;秦杰;马廉亭;;支架辅助弹簧圈栓塞治疗颅内动脉瘤相关并发症分析[J];中国临床神经外科杂志;2014年04期
9 刘建民;杨鹏飞;;血管重建:颅内动脉瘤介入治疗新篇章[J];中国卒中杂志;2013年11期
10 伍强军;杨鹏飞;黄清海;刘建民;;颅内动脉瘤介入治疗后复发的危险因素分析及诊治进展[J];中国卒中杂志;2013年11期
相关硕士学位论文 前1条
1 陈凡帆;破裂颅内动脉瘤患者介入治疗后早期预后的相关危险因素[D];广州医学院;2011年
，本文编号：2255003
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2255003.html
最近更新
教材专著
