比较Lvis支架辅助弹簧圈和Solitaire支架辅助弹簧圈栓塞治疗颅内破裂宽颈动脉瘤的安全性和有效性
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摘要
目的比较Lvis支架辅助弹簧圈和Solitaire支架辅助弹簧圈栓塞治疗颅内破裂宽颈动脉瘤的安全性和有效性。方法对2014年6月—2017年8月于宿州市第一人民医院脑血管病诊疗中心使用Lvis支架辅助弹簧圈或Solitaire支架辅助弹簧圈栓塞治疗颅内破裂宽颈动脉瘤的88例患者的病情资料进行回顾性分析,其中,观察组(Lvis支架辅助弹簧圈治疗组,45例)和对照组(Solitaire支架辅助弹簧圈治疗组,43例)。对2组患者栓塞治疗术后进行随访,采用GOS预后评分比较两种支架栓塞治疗的安全性,根据术后患者血管造影结果、Raymond分级标准比较两种支架栓塞治疗的有效性。结果术后GOS预后评分,观察组高于对照组,差异有统计学意义(P<0.05);患者血管造影结果显示,观察组的支架栓塞成功率高于对照组(P<0.05)、复发率低于对照组(P<0.05),差异有统计学意义;术后即刻Raymond分级和随访Raymond分级,观察组优于对照组,差异有统计学意义(P<0.05)。结论 Lvis支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤破裂时,能提高致密栓塞率,并能减少动脉瘤的复发率及再次出血率,安全性和有效性优于Solitaire支架辅助弹簧圈。
Objective To compare the safety and efficiency of Lvis stent assistant spring ring and Solitaire assistant spring ring in the treatment of the ruptured wide-necked intracranial aneurysm. Methods The clinical data of 88 patients with the ruptured wide-necked intracranial aneurysm undergoing Lvis stent assistant spring ring or Solitaire assistant spring ring in our hospital between June,2014 and August,2017 were analyzed retrospectively. Forty-five patients in the observation group received Lvis stent assistant spring ring,while 43 patients in the control group received Solitaire stent assistant spring ring. All the patients in the two groups were followed up to investigate the safety of the two methods by Glasgow Outcome Score( GOS). The result of computed tomography angiogram( CTA) and the Raymond-Roy Occlusion Classification( RROC) were used to compare the efficiency of two methods. Results The postoperative GOS in the observation group was higher than that in the control group( P < 0. 05); CTA result showed that the success rate in the observe group was higher than that in the control group( P < 0. 05),while the recurrence rate was lower than that in the control group( P < 0. 05); RROC immediate after the operation and during the follow-up in the observation group were better than those in the control group,the difference was statistically significant( P < 0. 05). Conclusion Livs stent assistant spring ring for intracranial wide-necked aneurysm can increase dense embolism rate,and decrease recurrence rate of arterial aneurysm and re-bleeding rate,with a better safety and efficiency level as compared with Solitaire stent spring ring.
Objective To compare the safety and efficiency of Lvis stent assistant spring ring and Solitaire assistant spring ring in the treatment of the ruptured wide-necked intracranial aneurysm. Methods The clinical data of 88 patients with the ruptured wide-necked intracranial aneurysm undergoing Lvis stent assistant spring ring or Solitaire assistant spring ring in our hospital between June,2014 and August,2017 were analyzed retrospectively. Forty-five patients in the observation group received Lvis stent assistant spring ring,while 43 patients in the control group received Solitaire stent assistant spring ring. All the patients in the two groups were followed up to investigate the safety of the two methods by Glasgow Outcome Score( GOS). The result of computed tomography angiogram( CTA) and the Raymond-Roy Occlusion Classification( RROC) were used to compare the efficiency of two methods. Results The postoperative GOS in the observation group was higher than that in the control group( P < 0. 05); CTA result showed that the success rate in the observe group was higher than that in the control group( P < 0. 05),while the recurrence rate was lower than that in the control group( P < 0. 05); RROC immediate after the operation and during the follow-up in the observation group were better than those in the control group,the difference was statistically significant( P < 0. 05). Conclusion Livs stent assistant spring ring for intracranial wide-necked aneurysm can increase dense embolism rate,and decrease recurrence rate of arterial aneurysm and re-bleeding rate,with a better safety and efficiency level as compared with Solitaire stent spring ring.
引文
[1]吕娇,黄静.综合护理干预对颅内动脉瘤血管内介入栓塞术的临床疗效及生活质量评分的影响分析[J].中国实用医药,2018,13(2):195-196.
[2]孙阳.颅内动脉瘤介入治疗时并发症的分析与防治[D].泸州:西南医科大学,2017.
[3]国家卫生计生委脑卒中防治工程编写委员会.中国动脉瘤性蛛网膜下腔出血诊疗指导规范[J].中国脑血管病杂志,2016,13(7):384-392.
[4]李帅,景雪峰.新型Solitaire AB支架辅助弹簧圈栓塞治疗后交通动脉宽颈动脉瘤36例[J].实用医学杂志,2016,32(2):280-283.
[5]陈骅,苏浩波,陈亮,等.LVIS支架不同释放方式在颅内宽颈动脉瘤中的应用[J].中国脑血管病杂志,2016,13(2):82-88.
[6]张卫生.多层螺旋CT血管造影诊断颅内动脉瘤价值[J].中华实用诊断与治疗杂志,2011,25(7):690-691.
[7]程吉斌.支架辅助弹簧圈栓塞技术在急性期治疗破裂宽颈动脉瘤的临床研究[D].芜湖:皖南医学院,2017.
[8]周磊.LVIS支架辅助弹簧圈栓塞在颅内宽颈动脉瘤中的临床应用研究[D].合肥:安徽医科大学,2017.
[9]Hong Y,Wang YJ,Deng Z,et al.Stent-assisted coiling versus coiling in treatment of intracranial aneurysm:a systematic review and meta-analysis[J].PLo S One,2014,9(1):e82311.
[10]周有东,敖祥生,刘汉东,等.支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析[J].中国临床神经外科杂志,2016,21(5):274-277,280.
[11]李浩然.LVIS支架辅助弹簧圈栓塞颅内动脉瘤的相关回顾性研究[D].济宁:济宁医学院,2017.
[12]冯明陶,冯政哲,方亦斌,等.支架与非支架辅助弹簧圈栓塞治疗颅内动脉瘤的Meta分析[J].中国脑血管病杂志,2016,13(1):17-24.
[13]周磊,聂庆彬,杜世伟,等.LVIS支架辅助弹簧圈栓塞在颅内宽颈动脉瘤的应用[J].中国微侵袭神经外科杂志,2017,22(5):216-219.
[14]冀方愿,宋英,杨新健.LVIS支架置入辅助弹簧圈栓塞治疗颅内宽颈动脉瘤[J].山东医药,2017,57(11):1-3.
[15]陈旭,詹健,张永安.LVIS支架不同释放法对颅内宽颈动脉瘤的应用分析[J].中国医疗器械信息,2016,22(22):26-27.
[16]罗明,闵强,黄乔春,等.Lvis支架在颅内宽颈动脉瘤栓塞中的应用[J].中国临床神经外科杂志,2016,21(8):458-460.
[17]陈骅,苏浩波,陈亮,等.LVIS支架不同释放方式在颅内宽颈动脉瘤中的应用[J].中国脑血管病杂志,2016,13(2):82-88.
[18]Cho YD,Sohn CH,Kang HS,et al.Coil embolization of intracranial saccular aneurysms using the Lowprofile Visalized Intraluminal Support(LVISTM)device[J].Neuroradiology,2014,56(7):543-551.
[19]Fiorella D,Arthur A,Boulos A,et al.Final results of the US humanitarian device exemption study of the low-profile visualized intraluminal support(LVIS)device[J].J Neurointerv Surg,2016,8(9):894-897.
[2]孙阳.颅内动脉瘤介入治疗时并发症的分析与防治[D].泸州:西南医科大学,2017.
[3]国家卫生计生委脑卒中防治工程编写委员会.中国动脉瘤性蛛网膜下腔出血诊疗指导规范[J].中国脑血管病杂志,2016,13(7):384-392.
[4]李帅,景雪峰.新型Solitaire AB支架辅助弹簧圈栓塞治疗后交通动脉宽颈动脉瘤36例[J].实用医学杂志,2016,32(2):280-283.
[5]陈骅,苏浩波,陈亮,等.LVIS支架不同释放方式在颅内宽颈动脉瘤中的应用[J].中国脑血管病杂志,2016,13(2):82-88.
[6]张卫生.多层螺旋CT血管造影诊断颅内动脉瘤价值[J].中华实用诊断与治疗杂志,2011,25(7):690-691.
[7]程吉斌.支架辅助弹簧圈栓塞技术在急性期治疗破裂宽颈动脉瘤的临床研究[D].芜湖:皖南医学院,2017.
[8]周磊.LVIS支架辅助弹簧圈栓塞在颅内宽颈动脉瘤中的临床应用研究[D].合肥:安徽医科大学,2017.
[9]Hong Y,Wang YJ,Deng Z,et al.Stent-assisted coiling versus coiling in treatment of intracranial aneurysm:a systematic review and meta-analysis[J].PLo S One,2014,9(1):e82311.
[10]周有东,敖祥生,刘汉东,等.支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析[J].中国临床神经外科杂志,2016,21(5):274-277,280.
[11]李浩然.LVIS支架辅助弹簧圈栓塞颅内动脉瘤的相关回顾性研究[D].济宁:济宁医学院,2017.
[12]冯明陶,冯政哲,方亦斌,等.支架与非支架辅助弹簧圈栓塞治疗颅内动脉瘤的Meta分析[J].中国脑血管病杂志,2016,13(1):17-24.
[13]周磊,聂庆彬,杜世伟,等.LVIS支架辅助弹簧圈栓塞在颅内宽颈动脉瘤的应用[J].中国微侵袭神经外科杂志,2017,22(5):216-219.
[14]冀方愿,宋英,杨新健.LVIS支架置入辅助弹簧圈栓塞治疗颅内宽颈动脉瘤[J].山东医药,2017,57(11):1-3.
[15]陈旭,詹健,张永安.LVIS支架不同释放法对颅内宽颈动脉瘤的应用分析[J].中国医疗器械信息,2016,22(22):26-27.
[16]罗明,闵强,黄乔春,等.Lvis支架在颅内宽颈动脉瘤栓塞中的应用[J].中国临床神经外科杂志,2016,21(8):458-460.
[17]陈骅,苏浩波,陈亮,等.LVIS支架不同释放方式在颅内宽颈动脉瘤中的应用[J].中国脑血管病杂志,2016,13(2):82-88.
[18]Cho YD,Sohn CH,Kang HS,et al.Coil embolization of intracranial saccular aneurysms using the Lowprofile Visalized Intraluminal Support(LVISTM)device[J].Neuroradiology,2014,56(7):543-551.
[19]Fiorella D,Arthur A,Boulos A,et al.Final results of the US humanitarian device exemption study of the low-profile visualized intraluminal support(LVIS)device[J].J Neurointerv Surg,2016,8(9):894-897.