摘要
目的探讨自膨式支架治疗椎-基底动脉巨大夹层动脉瘤的方法及效果。方法 10例椎-基底动脉巨大夹层动脉瘤均行血管内治疗并随访。结果术后即刻造影显示6例支架植入处血流发生明显改变,夹层扩张处缩小,4例无明显改变。术中无血栓事件及动脉瘤破裂出血,1例出现严重血管痉挛,应用罂粟碱后迅速缓解。临床随访3～30个月,8例头晕病例中有7例症状消失或减轻;7例术前饮水呛咳病例症状消失4例,减轻2例,1例无变化。造影随访10例,其中1例单支架治疗的患者五个月后夹层动脉瘤复发,球囊闭塞椎动脉,8个月后死于脑干衰竭。结论对于椎-基底动脉巨大夹层动脉瘤,采用单支架治疗效果不佳,多支架技术可以缓解症状并可能修复夹层,但其长期疗效有待进一步随访。
Objective To investigate the method to treat vertebrobasilar arteries giant dissecting aneurysms with self-expanding stents. Methods The clinical data of 10 patients with vertebrobasilar arteries giant dissecting ancurysms, which were endovascularly treated by self-expanding stents from October, 2004 to September, 2011, were analyzed retrospectively. Results The cerebral angiogram immediately after the treatment showed that the significant changes occurred in the blood flow of vertebrobasilar arteries into which the stents were implanted and the enlarged segments of dissecting artery became smaller. No thrombotic event and intraoperative aneurysm rupture happened, but 1 patient had intraoperative severe vasospasm which was relieved rapidly after the application of papaverine. Follow-up time ranged from 3 to 30 months. The dizzy symptom disappeared or was relieved in 7 and was unchanged in 1 of 8 patients with dizziness before the operation. The associated-drinking cough disappeared in 4, was relieved in 2 and was unchanged in 1 of 7 patients with associated-drinking cough before the operation. The dissecting aneurysms recurrence 5 months after the operation in 1 patient who died 8 months after undergoing occlusion of the vertebral artery with balloons. Conclusions The curative effect of single stent technique on the vertebrobasilar artery giant dissecting aneurysms is poor. The symptoms may be alleviated and dissecting arteries may be repaired by the multiple stents technique in the patients with giant dissecting aneurysms of the vertebrobasilar arteries, on which the long-term curative effect of the multiple stents technique should be further observed.
出处
《中国临床神经外科杂志》
2013年第6期332-334,共3页
Chinese Journal of Clinical Neurosurgery
关键词
椎-基底动脉
夹层动脉瘤
血管内治疗
多支架
Vertebrobasilar artery
Dissecting aneurysm
Endovascular therapy
Multiple stents
