摘要
目的总结血管内治疗椎动脉夹层动脉瘤的疗效和经验。方法 2001年12月至2011年12月收治70例椎动脉夹层动脉瘤患者,其中血管内治疗51例58枚椎动脉夹层动脉瘤。51例中,动脉瘤破裂出血32例,脑缺血19例。回顾性评估术后即刻和术后12个月脑血管造影以及临床疗效。结果成功治疗所有58枚夹层动脉瘤,其中永久闭塞动脉瘤和(或)椎动脉9枚,单纯性弹簧圈栓塞5枚,单纯性支架治疗6枚,支架辅助弹簧圈栓塞35枚,覆膜支架治疗3枚。术后即刻完全栓塞38枚,部分栓塞20枚。术后12个月复查47例53枚动脉瘤,46枚完全栓塞,部分栓塞中12枚达到完全栓塞,4枚保持稳定。经支架辅助弹簧圈栓塞的椎动脉夹层动脉瘤的完全栓塞率达100%,术后无再出血病例。结论血管内治疗椎动脉夹层动脉瘤安全、有效,首选支架辅助弹簧圈栓塞治疗。
Objective To evaluate the efficacy of endovascular treatment of vertebral artery dissecting aneurysms, and to summarize authors＇ experience. Methods During the period from Dec. 2001 to Dec. 2011, a total of 70 patients with vertebral artery dissecting aneurysms were admitted to authors＇ hospital. Among the 70 patients, endovascular treatment was carried out in 51 （58 lesions in total）. Of the 51 patients, subarachnoid hemorrhage due to ruptured aneurysm was seen in 32 and cerebral ischemia in 19. hnaging findings on cerebral angiography performed immediately after the procedure and 12 months after the treatment were analyzed and the clinical effectiveness was evaluated. Results All the 58 vertebral artery dissecting aneurysms were successfully treated with endovaseular treatment. The interventional procedures included permanent occlusion of vertebral artery dissecting aneurysms and/or vertebral artery （n = 9）, pure coil embolization （n = 5）, simple stent implantation （n = 6）, stent-assisted coil embolization （n = 35） and covered-stent implantation （n = 3）. The angiography performed immediately after the procedure showed that complete occlusion of the aneurysm was obtained in 38 patients and partial occlusion of the aneurysm was obtained in 20 patients. Follow-up examinations with angiography 12 months after the treatment revealed that 46 aneurysms out of 53 aneurysms in 47 patients were completely occluded, and among the 20 partially- occluded aneurysms 12 became completely obstructed and 4 remained stable. The complete occlusion rate in the patients receiving stent-assisted coil embolization therapy was 100%. No re- bleeding occurred in all patients. Conclusion For the treatment of vertebral artery dissecting aneurysms, endovascular treatment is safe and effective. The stent- assisted coil embolization should be considered to be the treatment of first choice.
出处
《介入放射学杂志》
CSCD
北大核心
2013年第7期529-534,共6页
Journal of Interventional Radiology
关键词
夹层动脉瘤
椎动脉
血管内治疗
弹簧圈
支架
dissecting aneurysm
vertebral artery
endovascular treatment
coil
stent
