Pipeline栓塞装置治疗海绵窦段和眼动脉段动脉瘤初步随访分析  

The application of Pipeline embolization device in treating intracranial aneurysms located between cavernous sinus segment and ophthalmic artery segment

作　　者：刘涛[1] 那世杰[1] 庄宗 凌海平 张庆荣 杭春华 LIU Tao;NA Shijie;ZHUANG Zong;LING Haiping;ZHANG Qingrong;HANG Chunhua(Department of Neurosurgery, Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province 210000, China)

机构地区：[1]南京大学医学院附属鼓楼医院神经外科,210000

出　　处：《介入放射学杂志》2018年第12期1127-1132,共6页Journal of Interventional Radiology

摘　　要：目的探讨Pipeline栓塞装置(PED)治疗颈内动脉海绵窦段动脉瘤(CCA)和颈内动脉眼动脉段动脉瘤(COA)的安全性和有效性。方法回顾性分析2015年7月至2016年12月南京鼓楼医院经DSA确诊为CCA、COA及多发动脉瘤并接受PED治疗患者的临床资料。结果共纳入21例患者(27枚动脉瘤),其中男4例,女17例;年龄27～74岁,平均(57±17)岁;大型/巨大型CCA、COA 15例,多发性COA 5例,微小型COA 1例;平均瘤体直径10.2 mm(2.5～25.3 mm)。术中共植入24枚PED(3例各植入2枚);18例PED结合弹簧圈疏松栓塞,3例仅植入PED。术后即刻造影显示瘤腔内对比剂不同程度滞留,大型/巨大型动脉瘤可见典型"半月征",载瘤动脉均通畅。术后随访6～12个月,所有患者症状均得到缓解,动脉瘤完全闭塞率为88.9%(24/27)。结论 PED治疗CCA、COA及多发动脉瘤安全有效,随访结果满意。但仍需大样本远期前瞻性随访验证。Objective To discuss the safety and effectiveness of Pipeline embolization device(PED)in treating carotid-cavernous aneurysms(CCA)and carotid-ophthalmic aneurysms(COA).Methods Theclinical data of 21 patients with DSA-proved CCA,COA or multiple aneurysms,who were admitted toNanjing Drum Tower Hospital of China during the period from July 2015 to December 2016 and received PEDtreatment,were retrospectively analyzed.Results A total of 21 patients(27 aneurysms in total)wereenrolled in this study.The patients included 4 males and 17 females,with a mean age of(57±17)years(27-74 years).Large or giant CCA or COA was found in 15 patients,multiple COA in 5 patients,and micro COAin one patient.The mean tumor diameter was 10.2 mm(2.5-25.3 mm).A total of 24 PEDs were implanted in21 patients,among them 2 PEDs were used in each of 3 patients.PED combined with spring coil looseembolization was employed in 18 patients,and only PED was adopted in 3 patients.Angiography performedimmediately after embolization revealed that in aneurysm cavity there was different degrees of contrastretention,typical "meniscus sign" could be seen in the large or giant aneurysms,and all parent arteries wereunobstructed.The patients were followed up for 6-12 months and the clinical symptoms were relieved in allpatients.The complete occlusion rate of aneurysms was 88.9%(24/27).Conclusion For the treatment ofCCA,COA and multiple aneurysms ,the use of PED is safe and effective ,the follow-up results aresatisfactory.However,its long-term effectiveness needs to be further verified by prospective large samplestudies.

关 键 词：Pipeline栓塞装置 海绵窦段动脉瘤 眼动脉段动脉瘤 动脉瘤闭塞率 

分 类 号：R743.4[医药卫生—神经病学与精神病学]