早期血管内栓塞术治疗破裂性后交通动脉瘤中远期效果分析  

Early endovascular embolization treatment for the ruptured posterior communicating artery aneurysm:analysis of the mid-term and long-term effects

作　　者：王舒婷[1] 虞希祥[1] 乔彬彬[1] 李成[1] 柳玉芳[2] 施振静[1] 施昌盛[1] 朱国庆[1] 

机构地区：[1]温州医科大学附属第三医院介入科,浙江瑞安325200 [2]山西医科大学第一医院神经内科

出　　处：《介入放射学杂志》2015年第10期843-845,共3页Journal of Interventional Radiology

基　　金：浙江省医药卫生科技计划项目(2015KYB369)

摘　　要：目的探讨早期血管内栓塞术治疗破裂性后交通动脉瘤的中远期效果。方法对36例患者(36枚)破裂性后交通动脉瘤行早期血管内栓塞术,根据Raymond分级方法评估栓塞效果。制订统一影像学复查计划,术后0.5、1、2、3、5年随访分析中远期疗效。结果 36例患者(36枚)破裂性后交通动脉瘤栓塞成功率为100%。Raymond分级评估显示32例患者为1级,2例为2级,2例3级。5例患者(13.89%)动脉瘤复发(随访0.5年1例,2年1例,3年1例,5年2例),复发后再次破裂1例(2.78%),随访期间无死亡病例。结论早期血管内栓塞术治疗破裂性后交通动脉瘤可有效改善蛛网膜下腔出血患者预后,定期影像学随访复查可及时发现动脉瘤复发及再发,采取有效干预措施有助于防止其继续加重和破裂。Objective To evaluate the mid-term and long-term effects of early endovascular emboli- zation in treating ruptured posterior communicating artery aneurysm. Methods Early endovascular embolization therapy was carried out in 36 patients with ruptured posterior communicating artery aneurysm （36 aneurysms in total）, and the effects of embolization therapy were evaluated by using Raymond grading method. The unified imaging review program was formulated, and the mid-term and long-term effects were evaluated at half, 1, 2, 3 and 5 years after the treatment. Results The technical success rate was 100% in 36 patients （36 aneurysms in total）. Raymond grading evaluation showed that grade I was seen in 32 patients, grade ]I in 2 patients, and grade m in 2 patients. Recurrence of aneurysm was found in 5 patients （13.89%） at half （n=l）, 2 （n=l）, 3 （n=l） and 5 years （n=2） after the treatment. Re-rupture of the recurrent aneurysm was seen in one patient （2.78%）. No death occurred during the following-up period. Conclusion Early endovascular embolization for ruptured posterior communicating artery aneurysm can effectively improve the prognosis of subarachnoid hemorrhage, and regular imaging examination can promptly detect the recurrence of aneurysm. Effective interventions are helpful for preventing deterioration and rupture of aneurysm.

关 键 词：血管内栓塞术 后交通动脉瘤 疗效 随访 

分 类 号：R743[医药卫生—神经病学与精神病学]