支架辅助弹簧圈治疗未破裂椎动脉夹层动脉瘤的疗效分析  

Stent-assisted coiling for unruptured vertebral dissecting aneurysm

作　　者：李辉[1] 李西锋[1] 何旭英[1] 段传志[1] 张炘[1] 刘彦超[1] 朱国辉[1] 

机构地区：[1]南方医科大学珠江医院神经外科广东神经外科研究所广东省脑功能修复与再生重点实验室,广州市510282

出　　处：《实用医学杂志》2015年第9期1418-1420,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81271315);广东省科技计划项目(编号:2012B031800131)

摘　　要：目的：探讨支架辅助栓塞技术治疗未破裂的椎动脉夹层动脉瘤的疗效。方法：回顾性分析59例支架辅助栓塞术治疗未破裂的椎动脉夹层动脉瘤患者的临床资料及预后。所有患者按治疗方式分为两组：单一支架结合弹簧圈治疗31例（单一支架组），双支架结合弹簧圈辅助栓塞28例（多重支架组），比较两组患者术后即刻动脉瘤栓塞程度、预后改良Rankin评分（mRS）、动脉瘤复发率。结果：56例患者预后良好（mRS 0～1分），两组预后 mRS 评分比较差异无统计学意义（P ＝0．24），多重支架组动脉瘤即刻栓塞率明显高于单一支架组（75．0％ vs．41．9％， P ＝0．010），且多重支架组动脉瘤复发率低于单一支架组（0％ vs．19．4％，P ＝0．043）。结论：支架辅助栓塞治疗未破裂的椎动脉夹层动脉瘤疗效确切，并发症少，多重支架结合弹簧圈技术可明显提高动脉瘤的栓塞程度，降低动脉瘤的复发率，其疗效还需大宗病例进一步验证。Objective To evaluate the efficacy of stent-assisted coiling in the treatment of unruptured vertebral dissecting aneurysm. Methods We retrospectively reviewed 59 consecutive patients with unruptured vertebral dissecting aneurysms that underwent endovascular treatment. 31 patients received single stent-assisted coiling, 28 patients received multiple stent-assisted coiling. Results Clinical outcome was favorable in 56 of the 59 patients, the modified Rankin Scale score had no difference in both groups （P = 0.24）. The immediate obliteration grade in multiple-stent group was higher than that in single-stent group （75.0% vs. 41.9%, P=0.010）. What′s more, the recurrence rate was lower in multiple-stent group （0% vs. 19.4%, P = 0.043）. Conclusions Stent-assisted coiling in the treatment of unruptured vertebral dissecting aneurysm is safe and effective , multilayer disposition of stents with coils will decrease the complications and facilitate the aneurysmal occlusion. Larger , prospective studies are necessary to explore the long-term outcomes of reconstruction therapy.

关 键 词：动脉瘤  夹层 未破裂椎动脉夹层动脉瘤 支架辅助栓塞术 复发 预后 

分 类 号：R651.1[医药卫生—外科学]