颅内后循环动脉瘤的血管内治疗  

Endovascular Treatment of Posterior Intracranial Circulation Aneurysms

作　　者：侯临江 张骞 马士朋 HOU Lin-jiang;ZHANG Qian;MA Shi-peng(Hedong District People's Hospital,Linyi,Shandong Province,276034 China)

机构地区：[1]山东省临沂市河东区人民医院

出　　处：《中外医疗》2019年第11期54-56,共3页China & Foreign Medical Treatment

摘　　要：目的总结颅内后循环动脉瘤的血管内介入治疗经验,以提高其治疗水平。方法回顾性分析该院2015年12月—2017年12月间收治20例椎基底动脉系统动脉瘤行血管内介入治疗患者的临床资料。其中基底动脉顶端分叉部动脉瘤9例,基底动脉主干动脉瘤4例,大脑后动脉动脉瘤2例,椎动脉瘤3例,小脑后下动脉瘤2例。20例均行电解可脱性弹簧圈(GDC)动脉瘤栓塞治疗,其中5例宽颈动脉瘤加行球囊辅助瘤颈成形术,4例基底动脉主干梭形动脉瘤加行血管内支架置入治疗,基底动脉分叉部宽颈动脉瘤4例,采用球囊remodeling技术辅助GDC栓塞治疗,4例动脉瘤直径>10mm者加行载瘤动脉栓塞治疗。结果该组13例达全致密填塞,4例为90%以上栓塞,患者无并发症。3例大型、巨型椎动脉球形动脉瘤行载瘤动脉闭塞术。结论采用动脉瘤栓塞术治疗颅内后循环动脉瘤安全可靠。但对颅内后循环复杂动脉瘤,单纯用该手术效果不佳。Objective To summarize the experience of endovascular interventional therapy for intracranial posterior circulation aneurysms in order to improve their therapeutic level. Methods The clinical data of 20 patients with vertebral basilar artery aneurysm who underwent endovascular intervention in a hospital from December 2015 to December 2017 were retrospectively analyzed. There were 9 cases of bifurcation aneurysm of basilar artery, 4 cases of basilar artery aneurysm, 2 cases of posterior cerebral artery aneurysm, 3 cases of vertebral aneurysm and 2 cases of posterior inferior cerebellar aneurysm. 20 patients underwent electrocardiographic detachable coil (GDC) aneurysm embolization, including 5 cases of wide-necked aneurysm plus balloon-assisted neck angioplasty, and 4 cases of basilar artery spindle-shaped aneurysm plus endovascular stenting in the treatment, 4 cases of wide-neck aneurysm of the basilar artery bifurcation were treated with balloon remodeling technique to assist GDC embolization. 4 patients with aneurysm diameter >10 mm were treated with tumor-bearing arterial embolization. Results 13 cases of this group reached full dense packing, 4 cases were more than 90% embolization, and the patient had no complications. 3 cases of large, giant vertebral artery aneurysm underwent arterial occlusion. Conclusion Aneurysm embolization is safe and reliable for the treatment of intracranial posterior circulation aneurysms. However, for intracranial posterior circulation complex aneurysms, the effect of this surgery alone is not good.

关 键 词：颅内动脉瘤 动脉瘤栓塞术 血管内介入疗法 

分 类 号：R5[医药卫生—内科学]