neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2018-20-1-49-55neurosurgery-513Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTПРИМЕНЕНИЕ НИЗКОПРОФИЛЬНЫХ СТЕНТОВ В ЭНДОВАСКУЛЯРНОМ ЛЕЧЕНИИ СЛОЖНЫХ АНЕВРИЗМ СОСУДОВ ГОЛОВНОГО МОЗГАUSING OF LOW-PROFILE STENTS IN THE ENDOVASCULAR TREATMENT OF COMPLEX ANEURYSMS OF THE BRAINhttps://orcid.org/0000-0002-7406-9874КиселевВ. С.KiselevV. S.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087

neuro-surgeon@yandex.ruhttps://orcid.org/0000-0003-4767-9906ГафуровР. Р.GafurovR. R.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087

https://orcid.org/0000-0002-1325-8460СосновА. О.SosnovA. O.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087

https://orcid.org/0000-0002-4065-5736ПерфильевА. М.Perfil’evA. M.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

132/1 Nemirovicha-Danchenko St., Novosibirsk 630087

ФГБУ «Федеральный центр нейрохирургии» Минздрава РоссииРоссияFederal Neurosurgical Center, Ministry of Health of RussiaRussian Federation2018220420182014955Copyright © Киселев В.С., Гафуров Р.Р., Соснов А.О., Перфильев А.М., 20182018Киселев В.С., Гафуров Р.Р., Соснов А.О., Перфильев А.М.Kiselev V.S., Gafurov R.R., Sosnov A.O., Perfil’ev A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/513Введение

Введение. Совершенствование эндоваскулярного инструментария расширяет возможности лечения аневризм головного мозга. Применение низкопрофильных стентов позволяет выполнять операции в сложных случаях дистальных аневризм.

Цель исследования – оценка эффективности и безопасности хирургического лечения аневризм с применением низкопрофильных саморасширяющихся нитиноловых стентов.

Материалы и методы

Материалы и методы. В отделении сосудистой нейрохирургии с июня 2014 г. по декабрь 2016 г. с применением низкопрофильных стентов прооперированы 44 пациента с 45 аневризмами сосудов головного мозга.

Результаты

Результаты. Выполнено 46 эндоваскулярных вмешательств: в заднем отделе артериального круга большого мозга стенты имплантированы в 30 (65,2 %) случаях, в переднем отделе – в 16 (34,8 %). Тотальная окклюзия (Raymond–Roy I) сразу после операции достигнута у 35 (83,3 %) больных, субтотальная (Raymond–Roy II) – у 7 (17,7 %). Исход лечения был благоприятным у 44 (97,7 %), неблагоприятным – у 1 (2,3 %) больной. Летальных исходов не было.

Заключение

Заключение. Полученные результаты свидетельствуют о минимальной частоте осложнений, не превышающей риск таковых при естественном течении заболевания. Результаты контрольных ангиограмм в отдаленном периоде продемонстрировали стабильность тотально окклюзированных аневризм, минимальную частоту реканализации, а также повышение показателя радикальности субтотально эмболизированных аневризм.

Introduction

Introduction. Improvement of the endovascular equipment expands the possibilities in the treatment of complex aneurysms of the brain. The use of low-profile stents allowed performing operations on complex distal aneurysms. This publication assesses the effectiveness and safety of such operations.

Materials and methods

Materials and methods. In the department of vascular neurosurgery for the period from June 2014 to December 2016 using low-profile stent, 44 patients with 45 aneurysms of cerebral vessels were operated.

Results

Results. 44 patients with 45 cerebral aneurysms performed 46 endovascular interventions. Most stents were implanted in the posterior circulation – 30 (65.2 %), in the anterior circulation – 16 (34.8 %) patients. Total occlusion (Raymond–Roy I) immediately after surgery was achieved in 35 (83.3 %), subtotal (Raymond–Roy II) – 7 (17.7 %). A favorable outcome of treatment was obtained in 44 (97.7 %). An unfavorable result was obtained in 1 (2.3 %) patient. There was no mortality.

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The authors declare that there are no conflicts of interest present.