本文選題：顱內(nèi)復(fù)雜動脈瘤　切入點：Pipeline血流導(dǎo)向裝置　出處：《新疆醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討Pipeline血流導(dǎo)向裝置(PED)治療顱內(nèi)復(fù)雜動脈瘤的短期療效。方法:分析新疆醫(yī)科大學第一附屬醫(yī)院神經(jīng)外科自2015年4月至2016年10月應(yīng)用PED治療29例顱內(nèi)復(fù)雜動脈瘤患者的臨床資料,其中女22例,男7例;年齡在16—78歲之間(平均53.0±13.6)。29例患者共32個動脈瘤,頸內(nèi)動脈海綿竇段6個,頸內(nèi)動脈床突段18個,頸內(nèi)動脈巖骨段1個,后交通動脈瘤3個,椎動脈1個,小腦后下動脈瘤3個。小型動脈瘤(瘤體3mm-10mm)3個,中大型動脈瘤(瘤體10mm-25mm)15個,巨大動脈瘤(瘤體大于25mm)8個,梭型動脈瘤5個,復(fù)發(fā)動脈瘤1個。結(jié)果:32個動脈瘤共治療31個動脈,放置pipeline支架30枚,有1例應(yīng)用2枚支架,其余均使用1枚支架。單純PED植入10例,聯(lián)合彈簧圈治療19例,有2例在支架釋放后進行球囊擴張。2例(6.9%)分別在術(shù)后2小時和5天出現(xiàn)蛛網(wǎng)膜下腔出血而死亡。有25例患者得到術(shù)后6個月隨訪,其中21例患者獲得DSA隨訪,4例行頭顱MRA隨訪。在17例隨訪患者中,有23例(92.0%)患者動脈瘤完全或幾乎閉塞,動脈瘤不完全閉塞2例(8.0%)。結(jié)論:對于大型及巨大動脈瘤、寬頸動脈瘤、梭型動脈瘤等難治性復(fù)雜動脈瘤,PED提供了一種安全、有效的治療方式,其動脈瘤閉塞率高、并發(fā)癥發(fā)生率低。
[Abstract]:Objective: to investigate the short-term effect of Pipeline blood flow guide device (PED) in the treatment of complex intracranial aneurysms.Methods: the clinical data of 29 patients with complex intracranial aneurysms treated with PED from April 2015 to October 2016 in the first affiliated Hospital of Xinjiang Medical University were analyzed.There were 32 aneurysms, 6 cavernous sinus segments, 18 clinoid segments of internal carotid artery, 1 petrosal bone segment of internal carotid artery, 3 aneurysms of posterior communicating artery and 1 vertebral artery.3 aneurysms of posterior inferior cerebellar artery.There were 3 small aneurysms (3mm-10mm), 15 medium and large aneurysms (10mm-25mm), 8 giant aneurysms (larger than 25mm), 5 parenchymal aneurysms and 1 recurrent aneurysm.Results: 31 arteries were treated with 32 aneurysms, 30 pipeline stents were placed, 2 stents were used in 1 case, and 1 stent was used in the rest.Only 10 cases were implanted with PED and 19 cases were treated with coils. 2 cases underwent balloon dilatation after stent release. 2 cases died of subarachnoid hemorrhage 2 hours and 5 days after operation.Twenty-five patients were followed up 6 months after operation, 21 of them were followed up by DSA, 4 patients were followed up with cranial MRA.Of the 17 patients followed up, 23 had aneurysms completely or almost occluded and 2 had incomplete aneurysms.Conclusion: PED is a safe and effective treatment for large and large aneurysms, wide carotid aneurysms, fusiform aneurysms and other refractory complex aneurysms. The rate of aneurysm occlusion is high and the incidence of complications is low.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R743

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