Willis覆膜支架治疗颈内动脉海绵段假性动脉瘤与瘘  

Treatment of pseudoaneurysms and fistulas of internal carotid arteries cavernous segments with covered stent-graft

作　　者：廖旭兴[1] 钟伟健[1] 董安石[1] 段成斌 林发牧 邓其峻[1] 王辉[1] LIAO Xu-xing;ZHONG Wei-Jian;DONG An-shi;DUAN Cheng-bin;LIN Fa-mu;DENG Qi-Jun;WANG Hui(Department of Neurosurgery, Foshan Municipal First People's Hospital, Foshan 52800, China)

机构地区：[1]佛山市第一人民医院神经外科,广东528000

出　　处：《中国临床神经外科杂志》2018年第12期769-771,共3页Chinese Journal of Clinical Neurosurgery

基　　金：广东省佛山市医学科技攻关项目(201308089;20151020138);佛山市医学科研立项课题(20180051);广东省佛山市"十三.五"医学重点专科基金(2016906);佛山市杰出青年医学人才基金(2018132)

摘　　要：目的探讨使用Willis覆膜支架治疗颈内动脉海绵窦段假性动脉瘤与瘘的可行性、有效性。方法回顾性分析2013年1月到2017年12月收治的15例颈内动脉海绵窦段假性动脉瘤和1例颈内动脉海绵窦瘘的临床资料,均采用Willis覆膜支架置入术治疗。结果术后即刻血管造影显示病变完全消失,载瘤动脉通畅。术后死亡2例;其余14例术后随访6～24个月,均恢复正常工作,DSA或CTA随访未见复发,但1例放疗病人出现颈内动脉海绵窦段慢性闭塞。结论 Willis覆膜支架治疗颈内动脉海绵窦段假性动脉瘤与瘘成功率高,操作简单。Objective To investigate the feasibility and efficacy of the treatment of pseudoaneurysms and fistulas of internal arteries cavernous segment(ICACS)with the covered stent-graft.Methods The clinical data of16patients with pseudoaneurysms and fistulas of ICACS treated with covered stent-graft in recent5years were analyzed retrospectively.Of these16patients,15suffered from ICACS pseudoaneurysms and1from ICAS fistula.Results DSA immediately after the operation sowed that the pseudoneurysms and fistula disappeared completely and the parent arteries were free in all the patients.Two patients died of intracranial rebleeding respectively3and10days after the operation.The following-up from3to24months showed that all the surviving patients returned to normal work.DSA or CTA examination showed that no lesions recurred in14patients,but the internal carotid cavernous sinus was occluded after the stenting in1patients associated with nasopharyngeal carcinoma treating by radiotherapy.Conclusions The covered stent-graft is a safe and effective method to treat the ICACS hemorrhages caused by pseudoaneurysms and fistulas,but its effect should be confirmed by the long-term following up and the application of it to treatment of the more same patients.

关 键 词：假性动脉瘤 颈内动脉海绵窦段 颈内动脉海绵窦瘘 Willis覆膜支架 血管内治疗 疗效 

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]