多支架并行置放和重塑形治疗椎-基底动脉巨大夹层动脉瘤的中长期疗效  

Parallel placement of multiple stents and reconstruction technique for the treatment of giant vertebrobasilar dissecting aneurysms： A medium and long-term follow-up study

作　　者：梁永平[1] 王君[1] 曹向宇[1] 刘新峰[1] 李宝民[1] 李生[1] 葛爱丽[1] 冯慧敏[1] Liang Yongping;Wang Jun;Cao Xiangyu;Liu Xinfeng;Li Baomin;Li Sheng;Ge Aili;Feng Huimin(Department of Neurology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院神经内科,北京100853

出　　处：《中华神经外科杂志》2018年第8期778-781,共4页Chinese Journal of Neurosurgery

摘　　要：目的 探讨应用多支架并行置放和重塑形技术治疗椎-基底动脉巨大夹层动脉瘤的中长期疗效.方法 回顾性纳入2011年4月至2012年8月解放军总医院神经介入中心收治的6例椎-基底动脉巨大夹层动脉瘤患者,共6个动脉瘤,瘤体最大径为7.9～14.0 mm,均行多支架并行置放和重塑形治疗.采用改良Rankin量表评分（mRS）评估患者的预后.结果 6例患者共置入支架21枚,支架定位准确,释放顺利,覆盖满意.术后临床症状较术前明显改善.术后随访5～7年,数字减影血管造影随访结果显示,3例瘤体缩小,3例瘤体无明显变化.5例患者的临床症状较术前持续稳定改善,末次随访mRS评分为0分1例,1分3例,2分2例.结论 应用多支架并行置放和重塑形治疗椎-基底动脉巨大夹层动脉瘤,可长期保持动脉瘤的形态稳定或使其缩小,改善患者的临床症状,提高其生命质量.Objective To investigate the medium and long-term follow-up results of parallel placement of multiple stents and reconstruction technique for treatment of giant vertebrobasilar dissecting aneurysms.Methods Clinical data of 6 consecutive patients with 6 giant vertebrobasilar dissecting aneurysms admitted to Department of Neurology,Chinese PLA General Hospital from April 2011 to August 2012 were retrospectively reviewed.All patients were diagnosed with vertebrobasilar dissecting aneurysms by DSA whose sizes ranged from 7.9 to 14.0 mm.All patients were treated with parallel placement of multiple stents and reconstruction technique under general anesthesia.Modified Rankin Scale （mRS） was used to evaluate the outcomes.Results Six patients were successfully implanted with 21 stents.All patients＇ signs and symptoms were improved significantly.The follow-up period ranged from 5 to 7 years.All patients underwent DSA reexamination at follow-up,The aneurysmal size was decreased in 3 patients and remained the same in 3 others.Five patients reported permanently improved symptoms.The last follow-up revealved the mRS of 0 in 1 case,1 in 3 and 2 in 2.Conclusion Parallel placement of multiple stents and reconstruction technique for treatment of giant vertebrobasilar dissecting aneurysms could help control the dilatation of aneurysm in the medium and long-term follow-up and thus improve the patient＇s clinical symptoms and quality of life.

关 键 词：颅内动脉瘤 动脉瘤 夹层 血管内操作 椎-基底动脉 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]