未破裂颈动脉窝动脉瘤的血管内治疗  

Endovascular treatment of unruptured carotid cave aneurysms

作　　者：张广[1] 亓敬涛[1] 吴培[1] 周配权[1] 徐善才[1] 史怀璋[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,150001

出　　处：《中华神经外科杂志》2017年第8期790-793,共4页Chinese Journal of Neurosurgery

基　　金：吴阶平医学基金（320.6750.12189）

摘　　要：目的 探讨未破裂颈动脉窝动脉瘤的临床特点及血管内治疗的有效性、安全性,并总结未破裂颈动脉窝动脉瘤血管内的治疗经验.方法 回顾性纳入2013年11月至2016年11月哈尔滨医科大学附属第一医院神经外科采用血管内治疗的22例未破裂颈动脉窝动脉瘤患者,其中男3例（14％）,女19例（86％）.总结分析颈动脉窝动脉瘤的临床特点、治疗方法、并发症及随访结果.采用改良Rankin量表评分（mRS）评估患者的预后,以Raymond分级评估手术疗效.结果 22例未破裂颈动脉窝动脉瘤患者均应用支架辅助栓塞,其中19例（86％）动脉瘤术后即刻达到Raymond Ⅰ级栓塞,3例（14％）为RaymondⅡ级栓塞.1例动脉瘤术中支架内局部形成血栓,经盐酸替罗非班治疗后无神经功能缺失.10例患者1年后复查,其中9例达到Raymond Ⅰ级栓塞.所有患者出院及6个月mRS评分均为0分.结论 颈动脉窝动脉瘤患者以女性较为多见.血管内治疗是颈动脉窝动脉瘤的一种安全、有效的治疗方法.应用支架辅助栓塞技术,并选用柔软、顺应性强的微导管可有利于颈动脉窝动脉瘤的治疗.Objective To summarize the characteristics of carotid cave aneurysms and to investigate the safety and efficacy of endovascular treatment for this kind of aneurysms.Methods From November 2013 to November 2016,the clinical data of 22 patients with unruptured carotid cave aneurysms undergoing endovascular treatment,at the Department of Neurosurgery,the First Affiliated Hospital of Harbin Medical University,were collected.Among them,3 patients （14％） were male and 19 patients （86％） were female.Their clinical characteristics,outcomes,complications and follow-up results were analyzed retrospectively.Modified Rankin scale （mRS） was used to assess the outcomes and Raymond Scale was used to assess the safety and efficacy of endovascular treatment.Results All 22 patients were treated by stent assisted coiling.Raymond Ⅰ was reported in 19 patients （86％） and Raymond 2 was achieved in 3 patients （14％）.Thrombosis occurred in the stent in 1 patient during the operation who did not develop any neurological deficits after Tirofiban treatment.Ten patients underwent angiographic follow-up after 1 year and 9 patients achieved Raymond 1.The mRs score was 0 in all patients.Conclusions Carotid cave aneurysms seem to be more common in females.Endovascular treatment could be a safe and effective approach for carotid artery aneurysms.

关 键 词：颅内动脉瘤 颈动脉窝 血管内操作 治疗结果 

分 类 号：R651.12[医药卫生—外科学]