瘤腔内栓塞结合血管壁内支架重建治疗颅内假性动脉瘤  

Embolization combined with endovascular stenting for treatment of intracranial pseudoaneurysms

作　　者：王君[1] 李宝民[1] 李生[1] 曹向宇[1] 刘新峰[1] 张阿兰[1] 葛爱丽[1] 

机构地区：[1]解放军总医院神经外科,北京100853

出　　处：《南方医科大学学报》2011年第5期836-838,共3页Journal of Southern Medical University

基　　金：卫生部科研基金(200902004-05)

摘　　要：目的探讨血管内治疗颅内假性动脉瘤的效果。方法对17例颅内假性动脉瘤患者选用弹簧圈、NBCA胶栓塞及血管内支架置入等方法进行血管内治疗。术后即刻复查血管造影并进行造影随访评价血管内治疗效果。结果除1例栓塞过程中发生动脉瘤破裂引起死亡外,其余16例患者手术均获成功。动脉瘤腔弹簧圈致密填塞率:单纯瘤腔内弹簧圈栓塞组致密填塞率50%;支架辅助弹簧圈栓塞组的致密填塞率42.9%。15例3个月到2年随访,单纯瘤腔内弹簧圈栓塞组2例复发,给予支架辅助弹簧圈补充栓塞,疗效满意;支架辅助弹簧圈栓塞组动脉瘤消失。结论根据病变不同特点选择个体化的血管内治疗技术治疗假性动脉瘤,而瘤腔内栓塞结合血管壁内支架重建治疗颅内假性动脉瘤可最大限度的减少复发,提高治愈率,是一种安全、有效的治疗手段。Objective To evaluate the therapeutic effect of embolization combined with endovascular stenting in the for treatment of intracranial pseudoaneurysms. Methods Seventeen patients with intracranial pseudoaneurysms received endovascular treatment with coil placement,NBCA glue embolization and endovascular stenting,and the therapeutic effect was evaluated according to the findings in immediate postoperative and follow-up angiography. Results Fatal aneurysm rupture occurred in 1 case during embolization,and the surgical procedures were carried out smoothly in the remaining 16 cases. The aneurysm cavity dense coil packing ratio was 50% in coil embolization group and 42.9% in stent-assisted coil embolization group. In the follow-up for 3 months to 2 years,2 patients in coil embolization group experienced pseudoaneurysm recurrence and were managed successfully with additional embolization with coils and stent. Aneurysms were not found postoperatively in stent-assisted coil embolization group. Conclusion Embolization combined with endovascular stenting is a safe and effective treatment of intracranial pseudoaneurysms with minimized risk of recurrence.

关 键 词：假性动脉瘤 支架 栓塞 血管内治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]