:Application And Efficacy Analysis Of Stent-assisted Coil Embolization Technique In The Treatment Of Complex Aneurysms

Objective:1.Analysis the clinical and imaging characteristics of patients with complexl aneurysms2.Assess the safety, efficacy and short-term prognosis of stent-assisted coil embolization technique in the treatment of complex aneurysms3.Analysis the common complications of stent-assisted embolization of aneurysms, explore ways to reduce complications.Methods:Retrospectively analysis the28patients with complex intracranial aneurysms treated by stent-assisted embolization technique in the Neurosurgery, Second Hospital of Shandong University from October2011to October2013.Analysis of the clinical and imaging data, including the patient’s basic information, clinical manifestations, imaging characteristics, major complications, prognosis and follow-up results and so on.All patients take a DSA before the operation to make sure the morphology,diameter of the neck and body of the aneurysm and then embolization by the stent-assisted coil embolization technique.All28patients get a brain DSA review in one to three months after discharged based on the review result,they will have a brain DSA review again, treated again or have a telephone follow-up.ranging from3to24months, the patient when the patient was discharged and was discharged in According to the3months mRS outcome scale as the prognostic criteriaRESULTS:All the28cases of complicated aneurysms are not able to pure embolization, recurrence after pure embolism or dangerous to surgery turned to stent assisted embolism.1.28complex aneurysms are all successfully stent-assisted embolization, technical success rate is100%.26postoperative can be dense thrombosis,one residual aneurysm neck,one majority thrombosis.Totally used36self-expanding stents including four cases of application of the double stent patients (one case of recurrence in the original stent re-stent-assisted embolization), one case with three stents, one case of stent graft,3patients with stenosis used3stents.2.Preoperative Hunt-Hess class of the patients in this group are I-III, improved mRS score in postoperative patients are0to2points, the prognosis is good.18cases of ruptured aneurysm with stent assisted embolization, morbidity and mortality did not significantly increased compared with unfracture patients.Paitents combined with stenosis stenosis stent during the same period or later, the outcome are both good.3.Two patients developed acute thrombosis, giving cancontact artery thrombolysis,1case of postoperative imaging show the blood clots disappear.1case residual distal enhancement.2cases intraoperative cerebral vasospasm,reliefed after giving papaverine. no obvious postoperative hemorrhage and cerebral infarction.4.1-3months review,3cases relapse, show the coil compression tumor neck contrast filling or offshoring coil,1case for stent assisted coil embolization again,2cases continue to observe.3-24months review or telephone follow-up, no aneurysm rupture agarn.Conclusion:Using stent assisted coil embolization technology expanded the application range of interventional techniques in the treatment of intracranial aneurysm, and increase the rate of the dense embolization,It is a safe and effective treatment method, but its curative effect need to be more large sample of case studies and long-term follow-up observation.Its complications should cause enough attention, also need to standardize operation, timely symptomatic treatment, strengthen the perioperative management, review on time and so on, to reduce the incidence of complications and improve the prognosis of patients with complications.