脑血管介入中的血管变异及其临床意义  

Anatomic Variation of Vessels and Its Clinical Significance for Cerebrovascular Intervention

作　　者：贾晓军[1] 陈阳[1] 张猛[1] 杨珩[1] 周华东[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《解剖与临床》2008年第4期227-230,236,共5页Anatomy and Clinics

摘　　要：目的:通过血管介入法,观察脑动脉及其相关血管的变异类型,为临床神经介入手术提供参考依据。方法:对1090例脑血管病患者,常规行全脑四血管造影检查,分析总结常见血管解剖变异。结果:1090例患者中,发现主动脉弓上分支血管变异353处(32.39%);其中头臂干迂曲常见,占65.72%(232/353),其次为头臂干与左颈总动脉共干发出16.43%(58/353)和左颈总动脉自头臂干发出11.05%(39/353)。后交通动脉自颈内动脉发出处呈"漏斗"样扩张占23.32%(128/549)和大脑前动脉A1段发育低下或缺如占27.68%(152/549)。小脑后下动脉发自枕大孔下方(椎动脉颅外段)占35.33%(124/351)。结论:主动脉弓上分支、颈内动脉和椎-基底动脉系统存在着多种血管解剖变异。本研究对提高脑血管介入手术成功率和诊疗效果有重要参考价值。Objective：To observe the variation types of cerebral arteries and their related vessels via blood vessel intervention for providing clinical data to the cerebrovascular intervention.Methods：From 2005 to 2007,1091 inpatients,the average age of（67.2±8.4） years,included 708 males and 383 females in our hospital,accepted the routine digital substraction angiography（DSA）.The common variation types of vessels were analyzed and summarized on the basis of these patients＇ data.Results：353 of 1090 patients（32.39%）appeared variation at the branches of aortic arch,among which,the incidence rate of variation at circuitous brachiocephalic trunk was 65.72%（232/353）;the brachiocephalic trunk and left carotid common artery（CCA） derived from the same site accounted for 16.43%（58/353） and left CCA from the brachiocephalic trunk was 11.05%（39/353）.The incidence rate of posterior communicating artery expanding as a ＂funnel＂at the site of internal carotid artery senting out was 23.32%（128/549）.The A1 segment of anterior cerebral artery appearing as underdevelopment or absence was 27.68%（152/549）.The incidence rate of posterior inferior cerebellar artery deriving from the extracranial vertebral artery was 35.33%（124/351）.Conclusions：There are various variation occurred to the branches of aortic arch,internal carotid artery and vertebral and basilar artery.This study provides an important reference for increasing the achievement ratio of cerebrovascular intervention.

关 键 词：血管变异 脑血管介入 

分 类 号：R743[医药卫生—神经病学与精神病学]