支架辅助弹簧圈栓塞治疗大脑前远端动脉瘤的疗效分析  

Stent-assisted coiling for distal anterior cerebral artery aneurysm

作　　者：吴琪[1] 张鑫[1] 张庆荣[1] 文立利[1] 张翔圣[1] 薛锦[1] 陈姝娟[1] 邓金龙[1] 王汉东[1] 

机构地区：[1]南京军区南京总医院神经外科,南京医学博士210002

出　　处：《医学研究生学报》2018年第3期239-243,共5页Journal of Medical Postgraduates

基　　金：国家自然科学基金(81471183);江苏省"科教强卫工程"重点人才培养项目(ZDRCA2016094)

摘　　要：目的大脑前远端动脉瘤临床少见,治疗困难。文中探讨支架辅助弹簧圈栓塞大脑前远端动脉瘤的临床效果与随访结果。方法收集2014年11月至2017年3月南京军区南京总医院神经外科住院治疗的15例支架辅助弹簧圈栓塞大脑前远端动脉瘤患者资料,共15个大脑前远端动脉瘤。其中破裂动脉瘤4个,未破裂动脉瘤11个;8个动脉瘤位于A2段,7个位于A3段。运用支架辅助弹簧圈栓塞动脉瘤,并保留载瘤动脉。所有患者随访6~33个月。影像学检查或临床随访评价患者的预后。结果所有患者均未发生操作相关并发症,1例患者术后因蛛网膜下腔出血导致的脑血管痉挛死亡。9例患者影像学随访,结果显示9个动脉瘤完全闭塞。存活患者临床预后满意,14例存活患者最终格拉斯哥预后评分(GOS)均为5分,随访中患者未发生破裂出血与新发神经功能障碍。结论支架辅助弹簧圈栓塞大脑前远端动脉瘤安全、有效,短期复发率低。Objective Distal anterior cerebral artery aneurysm（DACAA） is rare and difficult to be treated.The aim of this study was to investigate the clinical effect of stent-assisted coiling in the treatment of DACAA.Methods We retrospectively analyzed the clinical data about 15 patients with 15 DACAAs treated by stent-assisted coiling,with all the aneurysms occluded and the parent arteries preserved,including 4 ruptured and 11 unruptured aneurysm,8 in the A2 and 7 in the A3 segment.The follow-up ranged from 6 to 33 months,during which we evaluated the prognosis of the patients by radiological and clinical examinations.Results There were no operation-related complications in any of the cases.One patient died of subarachnoid hemorrhage-induced cerebral vasospasm.Follow-up angiogram revealed complete occlusion of the aneurysms in 9 cases.The last follow-up Glasgow Outcome Scale score was 5 in all the 14 survived patients.No rupture,rebleeding or fresh neurologic deficits was observed in any of the patients.Conclusion Stent-assisted coiling is safe and effective,with a low short-term recurrence rate,in the treatment of distal anterior cerebral artery aneurysm.

关 键 词：颅内动脉瘤 大脑前动脉 血管内治疗 支架 

分 类 号：R739.4[医药卫生—肿瘤]