破裂椎基底动脉夹层动脉瘤介入治疗(附9例报告)  

Interventional treatment for ruptured vertebrobasilar dissecting aneurysm: Report of 9 cases

作　　者：方兴根[1] 李真保[1] 狄广福[1] 吴德刚[1] 

机构地区：[1]皖南医学院附属弋矶山医院神经外科,安徽芜湖241001

出　　处：《皖南医学院学报》2015年第1期43-46,共4页Journal of Wannan Medical College

基　　金：皖南医学院附属弋矶山医院人才引进基金项目(YR202205)

摘　　要：目的:总结颅内破裂椎基底动脉夹层动脉瘤的诊断和介入治疗经验。方法:分析9例颅内破裂椎基底动脉夹层动脉瘤的症状和影像检查结果,就其介入治疗策略作回顾总结。结果:临床表现为自发性蛛网膜下腔出血,积血以脑干前方脑池最为明显,DSA显示为血管的扩张和狭窄。采取支架植入辅助弹簧圈栓塞4例、单纯支架治疗2例,其余3例采用闭塞载瘤血管远近端治疗。8例恢复良好,Rankin评分小于3分者7例,4分者1例,死亡1例;6个月后随访未见动脉瘤显影。结论:积极采取保留或闭塞载瘤动脉的介入方法治疗破裂椎基底动脉夹层动脉瘤,可防止再出血。Objective： To summarize experiences in diagnosis and interventional management of ruptured vertebrobasilar dissecting aneurysm（ RVBD）.Methods： Clinical symptoms and imaging results as well as interventional strategies were reviewed in 9 cases of RVBD. Results： The clinical symptoms of RVBD were characterized by evident spontaneous subarachnoid hemorrhage that was dominant at the cisternal in front of the brain stem. Digital subtraction angiography（ DSA） usually exposed＂pearl and string＂sign. Interventional management of the rebleeding included stent-assisted coil embolization in 4 cases,simple use of stent in 2,and occlusion of the affected artery with Guglielmi detachable coil（ GDC） in another 3. Eight patients were better recovered and one death occurred. By Rankin score,7 cases were under 3 and one scored 4. Follow-up after 6 month showed no aneursym recanalization in the survivals. Conclusion： Interventional management shall be the favorable option for ruptured vertebrobasilar dissecting aneurysm.

关 键 词：椎动脉 夹层动脉瘤 支架植入 弹簧圈 

分 类 号：R743[医药卫生—神经病学与精神病学]