颅内后循环动脉瘤出血急性期介入治疗分析  

Interventional therapy for patients with ruptured posterior circulation aneurysms at acute stage:report of 22 cases

作　　者：钟俊 徐剑峰[1] 刘阳[1] 谢晓东[2] 高阳[1] 刘藻滨 曹辉[1] ZHONG Jun;XU Jian-feng;LIU Yang;XIE Xiao-dong;GAO Yang;LIU Zao-bin;CAO Hui(Department of Neurosurgery,The No.3 People's Hospital of Mianyang/Sichuan Mental Health Center,Mianyang 621000,China;Department of Neurosurgery,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]绵阳市第三人民医院/四川省精神卫生中心神经外科,四川621000 [2]四川大学华西医院神经外科,成都610041

出　　处：《中国临床神经外科杂志》2023年第4期243-245,共3页Chinese Journal of Clinical Neurosurgery

基　　金：四川应用心理学研究中心项目(CSXL-212B03);四川省医学科研课题计划(S21044)。

摘　　要：目的探讨颅内后循环动脉瘤出血急性期介入治疗的方法及临床疗效。方法回顾性分析2016年9月至2020年3月介入治疗的22例颅内后循环动脉瘤的临床资料。结果22例均在动脉瘤破裂后3 d内完成介入治疗,单纯弹簧圈栓塞9例,单支架辅助栓塞10例,“双导管”技术辅助栓塞2例,双支架技术辅助栓塞1例。术后即刻造影显示,Raymond分级Ⅰ级14例,Ⅱ级5例,Ⅲ级3例。无术中破裂出血、血栓事件等。1例大脑后动脉大动脉瘤术后4 d突发呼吸心跳停止死亡;其余21例随访3个月~1年,复查造影未见动脉瘤复发,GOS评分5分。结论颅内后循环动脉瘤出血急性期,根据病人具体情况,选择合适的栓塞技术进行栓塞治疗,创伤小,具有较高的安全性,效果良好。Objective To investigate the interventional treatment of ruptured posterior circulation aneurysms at acute stage and its clinical effectiveness.Methods The clinical data of 22 patients with ruptured posterior circulatory aneurysms who received interventional treatment from September 2016 to March 2020 were retrospectively analyzed.Results All 22 patients underwent interventional therapy within 3 days after aneurysm rupture,including 9 pateints with simple coil embolization,10 with single stent assisted embolization,2 with"double catheter"technique-assisted embolization and 1 with double stent technique-assisted embolization.Immediate postoperative angiography showed that Raymond gradeⅠin 14 payients,gradeⅡin 5,and gradeⅢin 3.There were no intraoperative rupture or thrombotic events.One patient with a large posterior cerebral artery aneurysm died of sudden respiratory and cardiac arrest 4 days after the operation.The follow up of the other 21 patients(3 months to 1 year)showed no aneurysm recurrence and a GOS score of 5 in all 21 patients.Conclusions For patients with ruptured posterior circulation aneurysms at acute stage,appropriate embolization technique selected according to the specific situation of the patient can obtain good outcomes with light trauma and high safety.

关 键 词：颅内动脉瘤 颅内后循环动脉瘤 颅内破裂动脉瘤 血管内介入治疗 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]