■在脑动脉瘤破裂的急性期,有限的设备可用,使治疗困难。我们旨在评估急性期破裂脑动脉瘤的线圈栓塞加支架置入术的结果。
我们评估了在2014年4月至2021年12月期间接受血管内治疗的169例连续蛛网膜下腔出血患者中的134例接受支架置入治疗的22例病例,其中134例在急性期接受了栓塞治疗。在难以用球囊辅助或双导管技术治疗的患者中使用支架。在两种或更多种抗血小板剂的负载下进行支架。
■患者的平均年龄为68.9岁,其中男性5名,重度14名(63.6%)(世界神经外科医师联合会四级,V).4例动脉瘤部位为前交通动脉,九岁的颈内动脉,大脑中动脉一分为二,椎-基底动脉六号,和大脑后动脉合二为一。13例动脉瘤形状为囊状,七个解剖,和梭形合二为一。支架用于宽颈动脉瘤12例,七个血管保存,三人救。平均最大直径为9.6mm。平均颈部尺寸为6.4mm。在8例和7例中发现了完全闭塞和颈部残留,分别。围手术期并发症发生率为45.5%(血栓栓塞5例,两种支架闭塞,两次再次出血,和脑出血)。结果包括7例患者的改良Rankin量表0-2,五中有4-5,九分之六。1例发生支架相关死亡。发病率和死亡率为18.2%。尽管支架用于破裂的急性期,他们被用于正确的理由。然而,并发症发生率很高:两例再出血,其中不完全闭塞是一个因素。
■应仔细确定急性破裂脑动脉瘤患者的支架放置位置,并努力减少栓塞和出血性并发症。然而,当其他选择非常困难时,这可能是一种有效的治疗选择。
UNASSIGNED: In the acute stage of ruptured cerebral aneurysms, limited devices are available, making the treatment difficult. We aimed to evaluate the outcomes of the coil embolization with stenting for the ruptured cerebral aneurysms in the acute stage.
UNASSIGNED: We assessed 22 cases treated with stenting among 134 of 169 consecutive patients with subarachnoid hemorrhages undergoing an endovascular treatment between April 2014 and December 2021, of which 134 underwent an embolization during the acute stage. A stent was used in the patients wherein the treatment with the balloon-assisted or double catheter technique was difficult. Stenting was performed under the loading of two or more antiplatelet agents.
UNASSIGNED: The mean age of the patients was 68.9 years, of which five were male and 14 (63.6%) had severe grade (World Federation of Neurosurgeons grade IV, V). The aneurysm site was the anterior communicating artery in four cases, internal carotid artery in nine, middle cerebral artery in two, vertebrobasilar artery in six, and posterior cerebral artery in one. The aneurysm shape was saccular in 13 cases, dissection in seven, and fusiform in two. Stents were used for wide-neck aneurysms in 12 cases, vascular preservation in seven, and rescue in three. The mean maximum diameter was 9.6 mm. The mean neck size was 6.4 mm. Complete occlusion and neck remnant were found in eight and seven cases, respectively. The perioperative complication rate was 45.5% (thromboembolism in five cases, stent occlusion in two, re-bleeding in two, and cerebral hemorrhage in one). The outcomes included modified Rankin Scale 0-2 in seven cases, 4-5 in five, and 6 in nine. Stent-related death occurred in one case. The rate of morbidity and mortality was 18.2%. Although stents were used in the acute stage of rupture, they were used for the right reasons. However, a high rate of complications occurred: two cases of re-bleeding, in which an incomplete occlusion was a factor.
UNASSIGNED: Stent placement in patients with the acute ruptured cerebral aneurysms should be carefully determined and efforts should be made to reduce the embolic and hemorrhagic complications. However, it may be an effective treatment option when other options could be extremely difficult.