后循环动脉瘤的血管内介入治疗  

Interventional endovascular therapy on posterior circulation aneurysms

作　　者：沈媛[1] 侍海存[1] 周桂龙[1] 钟建国[1] 赵强[1] 吴莉娟[1] 梁秀琳[1] 

机构地区：[1]东南大学医学院附属盐城医院神经内科,224000

出　　处：《临床神经病学杂志》2012年第3期214-216,共3页Journal of Clinical Neurology

摘　　要：目的探讨后循环动脉瘤血管内介入治疗的临床应用。方法 14例后循环动脉瘤患者Hunt&Hess分级分为Ⅱ级11例,Ⅲ级2例,Ⅳ级1例;数字减影血管造影(DSA)显示椎动脉瘤2例,小脑后下动脉远端动脉瘤5例,基底动脉尖动脉瘤2例,基底动脉末端动脉瘤1例,小脑前下动脉瘤2例,大脑后动脉瘤2例。入组者均给予血管内介入治疗,其中7例囊性动脉瘤采用单纯弹簧圈栓塞术,5例采用Onxy胶载瘤动脉局部栓塞术,分别有1例应用支架辅助微弹簧圈栓塞术及支架塑形术。结果术后DSA显示动脉瘤完全栓塞10例,近全栓塞3例。1例支架塑形术后梭形膨出明显好转。格拉斯哥预后量表评分为5分12例,3分1例,2分1例。随访3个月～5年,8例恢复正常,1例左侧偏瘫,1例死亡,4例失访。结论颅内后循环动脉瘤多为复杂动脉瘤,个体化血管内介入治疗是安全、有效的方法。Objective To explore the clinical application of interventional endovascular therapy on posterior circulation aneurysms（PCA）.Methods Fourteen PCA patients were graded into Ⅱgrade in 11 cases,Ⅲ grade in 2 cases and Ⅳ grade in 1 case according to Hunt ＆ Hess classification.Digital subtraction angiography（DSA） showed that there were vertebral aneurysm in 2 case,distal aneurysms of posterior inferior cerebellar artery in 5 cases,top basilar artery aneurysms in 2 cases,terminal aneurysm of basilar artery in 1 case,anterior inferior cerebellar artery aneurysms in 2 cases and posterior cerebral artery aneurysms in 2 cases.All of the PCA patients received the interventional endovascular therapy,including applied pure coil embolization in 7 cases with saccular aneurysms,local parent artery Onxy glue embolization in 5 cases,stent-assisted coil embolization and stent shapping in 1 case respectively.Results After the operation,DSA showed that the aneurysms were completely embolized in 10 cases,subtotally embolized in 3 cases.And in 1 case,the fusiform intamescentia was significantly improved after stent shaping.The score of Glasgow outcome scale was 5 points in 12 cases,3 points in 1 cases and 2 points in 1 cases.Followed-up 3 months to 5 years,the 8 cases were recover very well,1 case was hemiplegia and 1 case dead;4 cases were lost to followed-up.Conclusions Mostly of intracranial posterior circulation aneurysms are complex aneurysm.The therapy of individual endovascular interventional is safe and effective.

关 键 词：颅内后循环动脉瘤 血管内介入治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]