椎-基底动脉夹层动脉瘤的血管内治疗(附48例分析)  

Endovascular treatment of vertebrobasilar artery dissecting aneurysms(report of 48 cases)

作　　者：刘福德[1] 邓剑平[1] 张涛[1] 陈虎[1] 李帅[1] 王俭博 曲友直[1] 赵振伟[1] 

机构地区：[1]第四军医大学唐都医院神经外科 [2]解放军65635部队卫生队

出　　处：《中国临床神经外科杂志》2016年第6期353-356,共4页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨血管内栓塞治疗椎-基底动脉夹层动脉瘤(VBDAs)的效果。方法回顾性分析2010年6月至2015年8月血管内栓塞治疗的48例(破裂动脉瘤25例,未破裂23例)VBDAs的临床资料,采用支架辅助弹簧圈栓塞术29例,单纯支架置入术4例,动脉瘤并载瘤动脉闭塞术15例。结果术后即刻造影示完全栓塞28例,近全栓塞12例,不全栓塞8例。38例术后随访3个月至3年,无再出血或梗死,32例(破裂13例,未破裂19例)预后良好,6例(破裂5例,未破裂1例)不佳;术后复发5例(破裂2例,未破裂3例)。结论血管内治疗VBDAs是安全有效的,但存在动脉瘤复发可能,长期随访很有必要。Objective To summarize the long-term effects of endovascular treatment on vertebrobasilar dissecting aneurysms（VBDAs）.Methods The clinical data of 48 patients with 50 VBDAs, who received endovascular treatment from June, 2010 to August,2015, were analyzed retrospectively. Of 50 VBDAs, 25 ruptured and 25 did not. Thirty-one VBDAs were treated by stent-assisted coilsembolization, 4 only by stents and 15 and their parent arteries together by coils embolization.Results The angiograms immediately afterthe treatment showed that of 50 VBDAs, 29 were totally occluded, 12 subtotally and 9 in great part. Of 38 patients followed up by theimaging from 3 months to 3 years, 5 had relapse and 33 not. Of 38 patients followed up clinically from 3 months to 3 years, 32 wererecovered well and 6 not. Of 6 patients who were recovered poorly, 5 had ruptured VBDAs and 1 unruptured before the treatment.Conclusions The endovascular treatment is a safe and effective method to treat VBDAs, but long-term following-up is needed becauseVBDAs may recur after the endovascular treatment.

关 键 词：颅内动脉瘤 夹层动脉瘤 基底动脉 椎动脉 血管内治疗 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]