血管内治疗床突旁未破裂颅内动脉瘤的疗效分析  

Analysis of the Efficacy of Endovascular Treatment of Paraclinoid Unruptured Intracranial Aneurysms

作　　者：何宜轩 王冰 邓剑平 于嘉 赵振伟 HE Yi-Xuan;WANG Bing;DENG Jian-Ping;YU Jia;ZHAO Zhen-Wei(Department of Neurosurgery,Air Force Military Medical University,Tangdu Hospital,Xi’an 710038,China)

机构地区：[1]空军军医大学唐都医院神经外科,西安710038

出　　处：《中国卒中杂志》2021年第6期551-555,共5页Chinese Journal of Stroke

摘　　要：目的评估血管内治疗床突旁未破裂颅内动脉瘤(unruptured intracranial aneurysm,UIA)的安全性和有效性。方法回顾性纳入2017年1月-2019年12月于空军军医大学唐都医院神经外科连续收治的床突旁UIA患者。收集患者的基线资料和影像学资料,统计动脉瘤栓塞结果、围手术期并发症发生情况及预后不良(mRS>2分)比例;分析与动脉瘤术后复发的相关因素。结果最终纳入176例床突旁UIA患者,年龄23~74岁,平均54.7±9.6岁,其中男性32例(18.2%)。184枚接受血管内治疗动脉瘤RaymondⅠ级151枚(82.1%),RaymondⅡ级31枚(16.8%),RaymondⅢ级2枚(1.1%)。176例患者围手术期并发症发生11例(6.3%);151例随访患者中预后不良5例(3.3%);影像学随访114例患者中复发8例(7.0%)。单因素分析结果显示,未完全栓塞与动脉瘤术后复发存在一定关系(P=0.004)。结论床突旁UIA血管内治疗总体为安全和有效的,在治疗床突旁UIA时,应尽量完全栓塞。Objective To evaluate the safety and efficacy of endovascular treatment of paraclinoid unruptured intracranial aneurysms(UIA).Methods Patients with paraclinoid UIA admitted to Department of Neurosurgery of Tangdu Hospital,Air Force Military Medical University from January 2017 to December 2019 were included in this retrospective analysis.The collected data included the baseline data,imaging data,the results of aneurysms embolization,periprocedural complications and the proportion of poor prognosis(mRS>2 points).The factors associated with postprocedural recurrence of aneurysms were analyzed.Results A total of 176 patients were included in this analysis,with a mean age of 54.7±9.6 years(aged 23-74 years)and 32 males(18.2%).Among 184 aneurysms,RaymondⅠ151(82.1%),RaymondⅡ31(16.8%)and RaymondⅢ2(1.1%).Periprocedural complications occurred in 11 cases(6.3%);5 cases(3.3%)of the 151 patients with clinical follow-up had poor prognosis;8 cases(7.0%)of the 114 patients with imaging follow-up had aneurysms recurrence.Univariate analysis showed that incomplete embolization was associated with aneurysms recurrence(P=0.004).Conclusions Endovascular treatment of paraclinoid UIA was generally safe and effective,and complete embolization of paraclinoid UIA should be attempted.

关 键 词：未破裂颅内动脉瘤 血管内治疗 复发 

分 类 号：R743.4[医药卫生—神经病学与精神病学]