Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke) > Cerebral embolism

Clinical Study on the Stent-Assisted for the Intracranial Aneurysm

Author TianHongAn
Tutor ZhaoWei
Course Medical Imaging and Nuclear Medicine
Keywords Intracranial aneurysm Stent Angioplasty Complications
CLC R743.33
Type Master's thesis
Year 2013
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Objective:Retrospectively analyzed the clinical data with stent-assisted for the intracranial aneurysm. To summarize the method and technical points of stent-assisted angioplasty, and explore its security and efficacy. To analyze the complications of endovascular stent-assisted management for intracranial aneurysms, and explore the relationship of the stent characteristics and the related complications. Summarized the characteristics and the useing experience with the various types of stent, To provide theoretical support for selecting the appropriate individual stent. Analysis of the causes of complications, to summarize the strategy of the management of complications and discuss the practical way to reduce the complications. To provide the theoretical guidance for the prevention of the complications of intracranial aneurysm embolization in the future.Materials and Methods:During the period from Mar.2009to Mar.2013,a total of80patients with intracranial aneurysms were treated with the stent-assisted in authors’ hospital. Retrospective analysis of clinical data, the equipment of use, surgical complications and imaging follow-up results. Divided into four groups depending on the type of stent:the Neuroform stent group (N), the Leo stent group (L), the Solitaire stent group (S) and the Enterprise stent group (E). Selected the artery embolization, aneurysm rupture, stent migration and the stent collapse as the object for the analysis of complications. Comparatively analyzed the each group of stent complications, and research the relationship of the stent characteristics and the complications. Statistically analyzed of the complications, and analyzed the intraoperative and postoperative treatment,to evaluate the safety and efficacy of the strategies in the complications according to prognosis.Results:A total of103aneurysms in80patients were successfully treated (18cases multiple),and no case of treatment failure. A total of96stents was placed. Because of1case has used both types stents with no complications, it is not included in the analysis. The remaining79cases:there are27cases in N group (34.2%),33in L group(41.8%),9in S group (11.4%) and10in E group (12.6%). A total of25complications has been occured in stent-assisted management for intracranial aneurysms, the total incidence of complications was31.25%(25/80) in the present study. Of which14cases of arterial thrombosis, aneurysm rupture in8cases,2cases of stent migration, and1case of stent collapse. The stent group distribution of25cases of complications:N group (n=6), L group (n=16), S group (n=2) and the E group (n=1). The results of statistical analysis:The difference in the four groups overall was statistically significant(P<0.05); The difference in N groups was statistically significant when compared with L groups(P<0.05);The difference between N groups and L groups was statistically significant(P<0.05); However, L group compared with S group, S group compared with E group, N group compared with E group, N group compared with S group, the difference was not statistically significant(P>0.05). According to the GOS grade,the clinical follow-up results:67cases in the5grade(83.75%);3cases in the4grade(3.75%);4cases in the3grade(5%);0case in the2grade(0%);6cases in the1grade(7.5%).The imaging follow-up results:aneurysm recurrence in1case, stent restenosis in1case, no stent migration and scaffold collapse cases.Conclusion:Stent-assisted angioplasty technique is a safe and effective technical treatment of complex intracranial aneurysms. According to the situation you can be flexible to choose the sequential deploying stent technique,parallel deploying stent technique and the stent semi-deploying technique, especially the stent semi-deploying technique can reduce the difficulty of stent surgery operation and the incidence of complication, shorter operative time, It has considerable feasible.The type of stent and the incidence of complications in stent-assisted angioplasty for the Intracranial aneurysm has a certain relevance, therefore, a reasonable choice of individual stent can effectively reduce the incidence of surgical complications.

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