双支架错位重叠技术辅助弹簧圈栓塞治疗颈内动脉床突上段血泡样动脉瘤  

Treatment of blood blister-like aneurysms with double stents dislocation overlapping technique-assisted coils embolization

作　　者：蒋海平 赵世光[1] 史怀璋[1] 韩大勇[1] 王春雷[1] 陈鑫[1] 王开开 田松 JIANG Hai-ping;ZHAO Shi-guang;SHI Huai-zhang;HAN Da-yong;WANG Chun-lei;CHEN Xin;WANG Kai-kai;TIANSong(Department of Neurosurgery,The First Affiliated Hospital,Harbin Medical University,Harbin 150001,China;Department ofNeurosurgery,The First Affiliated Hospital,Shaoyang University,Shaoyang 422000,China)

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,哈尔滨150001 [2]邵阳医学院附属第一医院神经外科,湖南邵阳422000

出　　处：《中国临床神经外科杂志》2018年第11期708-710,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨双支架错位重叠技术辅助弹簧圈栓塞治疗颈内动脉床突上段血泡样动脉瘤(BBAs)的可行性、有效性及预后。方法回顾性分析2014年7月至2018年6月采用双支架技术辅助弹簧圈栓塞治疗的9例BBAs的临床资料。结果 9例均成功实施双支架错位重叠技术辅助弹簧圈栓塞治疗,术中即刻影像Raymond分级Ⅰ级5例,Ⅱ级1例,Ⅲ级3例。出院时改良Rankin量表(mRS)评分0分4例,3分2例,4分1例,死亡2例;术后90 d mRS评分0分5例,1分1例,3分1例。7例存活病人影像学随访1周～24个月,动脉瘤均完全闭塞,载流动脉无狭窄。结论双支架错位重叠技术辅助弹簧圈栓塞治疗颈内动脉床突上段BBAs是一种可行、有效的方法,可降低动脉瘤术后复发率,改善病人预后。Objective To analyze the feasibility, effectiveness and prognosis of blood blister- like aneurysms （BBAs） in the supraclinoid portion of the internal carotid artery with double stents dislocation overlapping technique- assisted coils embolization.Methods The clinical data of 9 patients with BBAs, who were treated by double stents dislocation overlapping technique-assisted coils embolization from July, 2014 to June, 2018, were analyzed retrospectively, including the data of diagnosis, treatment, following-up and so on. Results These 9 patients were successfully treated with double stents dislocation overlapping technique- assisted coils embolization. DSA performed immediately after the embolization showed that the embolization effect was imaging Raymond grade Ⅰ in 5 patients, grade Ⅱ in 1, and grade Ⅲ in 3. The modified Rankin scale （mRS） scores on the discharged were 0 point in 4 patients, 3 points in 2 and 4 points in 1, and 2 patients died. The following up 90 days after the operation showed that mRS scores were 0 point in 5 patients, 1 point in 1 and 3 points in 1. All the aneurysms were completely occluded and there was not stenosis of the parent arteries in all the 7 survivors followed up by imaging. Conclusion Double stents dislocation overlapping technique-assisted coils embolization is a feasible and effective method to treat BBAs.

关 键 词：血泡样动脉瘤 颈内动脉床突上段 双支架错位重叠技术 血管内治疗 弹簧圈 预后 

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]