血管内栓塞治疗床突旁动脉瘤的临床分析  

Endovascular embolization in treatment of paraclinoid aneurysms

作　　者：缪洪平[1] 杨云峰[1] 陈志[1] 牛胤[1] 蒋周阳[1] 唐卫华[1] 朱刚[1] 林江凯[1] 冯华[1] 

机构地区：[1]第三军医大学西南医院神经外科,全军神经外科研究所,重庆400038

出　　处：《第三军医大学学报》2012年第18期1866-1869,共4页Journal of Third Military Medical University

摘　　要：目的探讨床突旁动脉瘤的诊断、血管内栓塞的适应症、方法及并发证的防治。方法对40例(46个动脉瘤)床突旁动脉瘤患者进行回顾性研究。其中,单纯微弹簧圈栓塞21例,支架辅助微弹簧圈栓塞8例,球囊辅助微弹簧圈栓塞4例。术后进行CT、3D-CTA、MRI和/或3D-DSA随访检查,观察并分析疗效。结果 33例患者(38个动脉瘤)成功栓塞,7例患者放弃治疗。随访35例患者,5例失访。3个月至2年GOS评分,5分27例,4分3例,3分1例,2分1例,1分3例。28例经血管内栓塞治疗的患者未见动脉瘤新生或再通及出血症状发生。7例未治疗的患者中,未破裂的患者4例未发生出血,破裂的患者3例均发生再次出血死亡。结论血管内栓塞治疗床突旁动脉瘤能有效改善预后,3D-CTA、3D-DSA的应用能为床突旁动脉瘤的诊治、复查提供有效的帮助。Objective To analyze the diagnosis of paraclinoid aneurysm, and its indications for endo- vascular embolization and prevention for complications. Methods The clinical data of 40 cases of paraclinoid aneurysms （46） undergoing endovascular embolization in our department from January 2009 to May 2012 were retrospectively reviewed. Among the 40 cases, endovaseular coil embolization was used in 21 cases, stent-assis- ted coil embolization was used in 8, and balloon-assisted coil embolization was used in 4. There were 7 cases quitting the treatment. The efficiency of the treatment was analyzed, and postoperative follow-up was conducted by CT, 3D-CTA, MRI and/or 3D-DSA. Results Immediate post-procedure angiography showed that complete obliteration of aneurysm was achieved in 33 cases （38 aneurysms）. Thirty-five cases were followed up by 3D- CTA and/or DSA within 3 to 48 months. The final clinical outcomes showed Glasgow outcome score （GOS） was 5 in 27 patients, 4 in 3, 3 in 1, 2 in 1 and 1 in 3 cases. No recurrence and rebleeding was found in 28 cases with endovascular embolization treatment. In the 7 patients who quitted the treatment, 4 with unruptured aneu- rysm had no bleeding observed, and the 3 re-bleeding cases were die finally due to bleeding. Conclusion En- dovascular therapy is a minimally invasive, safe and effective treatment for paraclinoid aneurysms, which can be properly evaluated by 3 D-CTA and 3 D-DSA.

关 键 词：床突旁动脉瘤 血管内栓塞治疗 

分 类 号：R615[医药卫生—外科学] R651.12[医药卫生—临床医学]