Objective To investigate the perioperative complications and treatment measures of Solitaire AB stent for embolization of wide-necked cerebral aneurysms.Methods The clinical and imaging data of 116 patients with wide-necked cerebral aneurysms treated by using Solitaire AB stent-assisted embolization at the Department of Interventional Radiology,the First Affiliated Hospital of Zhengzhou University from February 2010 to February 2014 were analyzed retrospectively.The perioperative complications were observed.Its causes of occurrence were analyzed and the corresponding treatment measures were investigated.Results All stents were successfully implanted in place.The results of immediate DSA examination revealed that 55 of 120 aneurysms were embolized completely.There were 59 residual aneurysm necks,6 aneurysms were embolized partially.Ten patients had perioperative complicatios,3 were intraoperative aneurysm rupture,the bleeding of 2 patients was stopped after emergency packing,and 1 patient died;after having intraparenchymal hemorrhage,1 patient died of herniation at 5 h after stenting;4 had thrombotic complications,3 of them had blood flow recanalization after in-stent thrombolysis,and the efficacy of 1 case was poor and his blood flow was patent after a new Solitaire stent implantation;2 had stent migration when the stent was not detached during procedure,fortunately,it did not cause significant neurological damage.After procedure,114 patients were followed up for 3 to 37 months.Twelve patients had aneurysm recurrence and 5 were treated with intervention therapy again.Conclusions Solitaire AB stent-assisted coil embolization for the treatment of wide-necked aneurysms is a mature technique,but there are some complications.Therefore,the surgeons need to have good operative skills and rich experience.At the same time,the perioperative management should be strengthened in order to reduce the occurrence of complications and improve the prognosis of patients.%目的 探讨Solitaire AB支架辅助栓塞颅内宽颈动脉瘤围手术期出现并发症的处理措施.方法 回顾性分析郑州大学第一附属医院放射介入科2010年2月至2014年2月116例应用Solitaire AB支架辅助栓塞120个颅内宽颈动脉瘤患者的临床及影像学资料,观察围手术期并发症,分析其发生原因并探讨相应的处理措施.结果 所有支架均成功到位,即刻DSA检查结果显示:120个动脉瘤完全栓塞55个,瘤颈残留59个,部分栓塞6个.10例患者围手术期出现并发症:3例为术中动脉瘤破裂出血,紧急填塞后2例出血停止,1例死亡;1例患者支架置入术后5h出现脑实质出血后死于脑疝;4例患者出现血栓并发症,其中支架内溶栓后3例血流再通,1例效果欠佳给予1枚新的Solitaire AB支架置入后血流再通;2例术末解脱支架时出现支架移位,所幸未造成明显的神经功能损伤.术后114例患者获得随访,随访时间3～37个月,12例患者出现动脉瘤复发,5例给予再次的介入手术治疗.结论 Solitaire AB支架辅助弹簧圈栓塞治疗颅内宽颈动脉瘤是一项成熟的技术,但也存在一定的并发症,因而需要术者具有良好的手术技能和丰富的经验,同时应加强围手术期管理,以降低并发症的发生率和改善患者的预后.
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