双支架后释放技术辅助栓塞治疗颅内破裂椎动脉夹层动脉瘤的疗效  

Efficacy of dual stent-assisted coil embolization in ruptured vertebral artery dissecting aneurysms

作　　者：王磊 黄建煌[1] 黄迢华[1] 林金加 陈建宁[1] 宋建华[1] 姚正健[1] Wang Lei;Huang Jianhuang;Huang Tiaohua;Lin Jinjia;Chen Jianning;Song Jianhua;Yao Zhengjian(Department of Neurosurgery,Affiliated Hospital of Putian University,Putian 351100,China;Interventional Catheter Department,Affiliated Hospital of Putian University,Putian 351100,China)

机构地区：[1]莆田学院附属医院神经外科,莆田351100 [2]莆田学院附属医院介入导管室,莆田351100

出　　处：《中华神经医学杂志》2022年第3期273-277,共5页Chinese Journal of Neuromedicine

摘　　要：目的评估双支架后释放技术辅助弹簧圈栓塞治疗颅内破裂椎动脉夹层动脉瘤(VADAs)的疗效和安全性。方法选择莆田学院附属医院神经外科自2015年9月至2020年3月采用双支架后释放技术辅助弹簧圈栓塞治疗的17例颅内破裂VADAs患者(17个动脉瘤),术后即刻行DSA检查评估VADAs的栓塞程度,随访结束时采用改良Rankin量表(mRS)评分评估患者的预后,DSA检查判断动脉瘤的愈合情况。结果术后即刻DSA检查显示完全栓塞6例,次全栓塞8例,部分栓塞3例;2例患者围手术期死亡,2例术后出现颅神经麻痹症状。15例患者术后随访5~24个月,预后良好14例,预后不良1例;11例患者完成DSA随访,其中8例VADAs完全愈合,2例稳定,1例复发。结论双支架后释放技术辅助弹簧圈栓塞治疗颅内破裂VADAs安全、有效。Objective To evaluate the safety and efficacy of dual stent-assisted coil embolization in intracranial ruptured vertebral artery dissecting aneurysms(VADAs).Methods Seventeen patients with intracranial ruptured VADAs(17 aneurysms),treated with dual stent-assisted coil embolization in our hospital from September 2015 to March 2020,were recruited.DSA was performed immediately after surgery to evaluate the embolization degrees of VADAs.At the end of follow-up,modified Rankin scale(mRS)was used to evaluate the prognoses of these patients,and DSA was used to determine the healing status of aneurysms.Results The postoperative immediate DSA showed that total occlusion was achieved in 6 patients(35.3%),subtotal occlusion in 8(47.1%)and partial occlusion in 3(17.6%).Two patients died during the perioperative period and 2 patients presented symptoms of cranial nerve palsy after surgery.Fifteen patients were followed up for 5-24 months,14 were with good prognosis,and one was with poor prognosis.Eleven patients underwent DSA follow-up,which showed that 8 aneurysms healed completely,2 aneurysms were stable,and 1 aneurysm recurred.Conclusion Dual stent-assisted coil embolization may be an effective and safe treatment method for intracranial ruptured VADAs.

关 键 词：颅内动脉瘤 椎动脉夹层动脉瘤 双支架后释放技术 血管内治疗 

分 类 号：R651.1[医药卫生—外科学]