存在胚胎型大脑后动脉的后交通动脉动脉瘤：血管内介入治疗与手术夹闭治疗的比较  

Endovascular coiling of posterior communicating artery aneurysms in patients with fetal-type posterior cerebral artery： comparison with surgical clipping

作　　者：樊天禹[1] 向鹏[1] 黄云峰[1] 傅迎旭[1] 邓一平[1] 龚勇[1] 

机构地区：[1]长沙市中心医院神经外科,410004

出　　处：《国际脑血管病杂志》2015年第11期836-839,共4页International Journal of Cerebrovascular Diseases

摘　　要：目的在存在胚胎型大脑后动脉（fetal-type posterior cerebral artery，fPCA）的后交通动脉动脉瘤（posterior communicating artery aneurysm，PCoAA）患者中比较介入栓塞治疗与开颅手术夹闭的疗效。方法纳人合并fPCA的PCoAA患者，收集其基线临床资料，术后6个月采用改良Rankin量表（modified Rankin Scale，mRS）评估临床转归，评分≤2分认为转归良好。结果研究期间共纳入35例合并fPCA的PCoAA患者，23例采用介入栓塞治疗，12例采用开颅手术夹闭，2组患者在年龄、性别、术前Fisher分级、Hunt-Hess分级、基线GCS评分和动脉瘤分型方面无显著差异。介入栓塞组6个月转归良好率高于手术夹闭组，但无显著性统计学差异（65．22％对41．67％；P=0．282）。结论采用介入栓塞治疗合并fPCA的PCoAA的疗效与开颅手术夹闭相当。Objective To compare the efficacy of endovascular interventional treatment and surgical clipping in posterior communicating artery aneurysm （PCoAA） patients with fetal-type posterior cerebral artery （fPCA）. Methods The PCoAA patients with fPCA were enrolled. Their baseline clinical data were collected. The modified Rankin Scale （mRS） was used to assess the clinical outcomes at six months after procedure. The mRS score 0 - 2 was defined as good outcome. Results A total of 35 PCoAA patients with fPCA were enrolled into the study, 23 were treated with interventional embolization therapy and 12 were treated with craniotomy clipping. There were no significant differences in age, gender, preoperative Fisher grade, Hunt-Hess grade, baseline GCS scores, and aneurysm typing between the 2 groups. The good outcome rate of the interventional embolization group at 6 months was higher than that of the surgical clipping group, but there was no significant difference （65.22% vs. 41.67% ; P = 0. 282）. Results The efficacy of PCoAA using interventional embolization therapy combined fPCA is almost the same as craniotomy clipping.

关 键 词：颅内动脉瘤 大脑后动脉 栓塞 治疗性 治疗结果 

分 类 号：R651.12[医药卫生—外科学]