目的总结应用新型颅内支架Enterprise结合水解脱弹簧圈栓塞治疗颅内微小宽颈动脉瘤的技术及疗效。方法6例颅内微小宽颈动脉瘤(直径〈3mm,体/颈比〈1.5)采用Enterprise支架结合水解脱弹簧圈栓塞,其中5例采用先放置支架覆盖动脉瘤颈再将微导管经支架网孔放入动脉瘤腔填塞弹簧圈进行栓塞,1例将微导管进入瘤腔后再释放支架进行弹簧圈栓塞。术后3~6个月进行临床随访。结果6例全部技术成功,支架均满意到位,载瘤动脉通畅,无手术并发症;动脉瘤完全闭塞4例,闭塞95%以上2例。术后患者均恢复良好,3~6个月临床随访无再出血及脑血栓形成。结论联合使用Enterprise支架和水解弹簧圈栓塞治疗颅内微小宽颈动脉瘤是一种安全有效的方法,但其长期疗效仍需进一步观察。
Objective To make a preliminary investigation and summary of the technique and efficacy of the novel intracranial stent, Enterprise, together with hydro-detachable coils for the treatment of very small intracranial wide-necked aneurysms(diameter 3 mm and body-to-neck ratio 1.5).Methods Six cases with very small intracranial wide-necked aneurysms were treated with Enterprise stents and hydrodetachable coils.In 5 cases the Enterprise stent was implanted to cover the neck of the aneurysm, which was followed by the introduction of a microcatheter into the aneurysmal sac through the stent mesh to stuff hydrodetachable coils in order to fill the aneurysmal sac.In the remaining case, the microcatheter was placed into the aneurysmal sac before the Enterprise stent was inserted to embolize the aneurysm.Postoperative follow-up was conducted for 3-6 months.Results The operation was successfully completed in all 6 patients, with the implanted stents being in right place.The parent arteries remained patency in all patients.No complications occurred.Complete occlusion of aneurysmal cavity was obtained in four cases, and the occlusion degree of the aneurysmal cavity above 95% was seen in 2 cases.After the procedure, all the patients recovered well.Neither rebleeding nor symptoms related to thrombosis occurred during a clinic followup of 3-6 months.Conclusion Endovascular embolization with Enterprise stent together with hydrodetachable coils is a safe and effective method for the treatment of very small intracranial wide-necked aneurysms.However, its long-term effect needs to be further observed.