摘要目的 探讨Pipeline血流导向装置治疗颅内复杂动脉瘤的疗效及安全性.方法 回顾性纳入山东省6家医院2015年1月至2016年10月应用Pipeline血流导向装置治疗的48例颅内动脉瘤患者,共56个颅内动脉瘤.56个颅内动脉瘤的平均直径为(10.8±8.6)rmm;囊状动脉瘤33个(58.9％),不规则动脉瘤15个(26.8％),血泡样动脉瘤7个(12.5％),夹层动脉瘤1个(1.8％).55个(98.2％)动脉瘤位于颈内动脉,1个(1.8％)动脉瘤位于椎动脉.术后即刻采用Kamran分级法评估动脉瘤的栓塞程度.随访期间通过Cekirge分级评估动脉瘤的栓塞效果.结果 术后即刻动脉瘤Kamran分级1级13个(23.2％),2级20个(35.7％),3级11个(19.6％),4级12个(21.4％).术后7d内3例(6.3％)出现脑实质出血,2例发生缺血性卒中;共2例(4.2％)死亡.33例患者在术后3 ～16个月进行了随访,Cekirge分级Ⅰ级者占72.5％(29个),Ⅱ级者占12.5％(5个),Ⅲ级者占15.0％(6个).结论 应用Pipeline血流导向装置治疗颅内复杂动脉瘤的并发症发生率较低,早中期随访动脉瘤的完全闭塞率良好.

abstractsObjective To investigate the safety and efficacy of treatment of intracranial complex aneurysms using Pipeline embolization device (PED).Methods We retrospectively analyzed the clinical data of 48 patients (56 intracranial aneurysms) who were treated with PED at 6 hospitals in Shandong province from January 2015 to October 2016.The average diameter of 56 aneurysms was 10.8 ± 8.6 mm.There were 33 (58.9％) saccular aneurysms,7 (12.5％) blood blister-like aneurysms,1 (1.8％)dissecting aneurysm and 15 (26.8％) irregular shaped aneurysms.There were 55 (98.2％) aneurysms located at internal carotid artery and 1 (1.8％) located at vertebral artery.The instant efficacy of embolization was evaluated according to Kamran classification.The efficacy of embolization during the followup was assessed by Cekirge classification.Results Among all 56 aneurysms,Kamran grade 1 was reported in 13 (23.2％) aneurysms,grade 2 in 20 (35.7％),grade 3 in 11 (19.6％) and grade 4 in 12 (21.4％).The intraparenchymal hemorrhage rate was 6.3％ (3 cases) and the mortality rate was 4.2％(2 cases) within 7 days post operation.Thirty-three cases were followed up for 3-16 months post operation.Complete occlusion (Cekirge grade 1) was achieved in 72.5％ (29/40),neck filling (Cekirge grade 2) in 12.5％ (5/40) and incomplete occlusion with aneurysm filling (Cekirge grade 3) in 15.0％(6/40).Conclusion The complication rate seems relatively low in patients with intracranial aneurysms treated with PED and the complete occlusion rate of aneurysms is satisfactory in early and mid-term follow-up.