颈内动脉眼动脉段未破裂动脉瘤血管内治疗的并发症分析  

Analysis of complications of endovascular treatment of unruptured aneurysms in the ophthalmic artery segment of the internal carotid artery

作　　者：程魁红 赵刚[1,2] 江澈 张建波 徐承澍 张锡武 陈状 武肖娜 罗高权 Cheng Kuihong;Zhao Gang;Jiang Che;Zhang Jianbo;Xu Chengshu;Zhang Xiwu;Chen Zhuang;Wu Xiaona;Luo Gaoquan(First Clinical School of Medicine,Southern Medical University,Guangzhou,Guangdong 510515,China;Department of Neurosurgery,General Hospital of Southern Theater Command,PLA,Guangzhou,Guangdong 510010,China)

机构地区：[1]南方医科大学,广东广州510515 [2]南部战区总医院神经外科,广东广州510010

出　　处：《中国微侵袭神经外科杂志》2024年第2期65-69,共5页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：广东省自然科学基金资助项目(编号:2023A1515010673)。

摘　　要：目的总结血管内治疗颈内动脉眼动脉段未破裂动脉瘤的并发症,初步分析其发生的原因。方法回顾性分析应用血管内治疗的82例颈内动脉眼动脉段未破裂动脉瘤的病例资料,记录并发症发生情况,分析影响并发症发生的危险因素。结果围手术期并发症4例,总体并发症发生率为4.9%(4/82),发生术中血管痉挛2例,动脉瘤破裂出血1例,局部小穿支动脉受损1例。术后随访3~24个月,平均随访时间为(12.7±5.6)个月,均未出现支架内狭窄及永久性眼部并发症。病人性别、年龄、高血压病、糖尿病、高脂血症、动脉瘤大小及动脉瘤形态因素在颈内动脉眼动脉段未破裂动脉瘤血管内治疗并发症的发生率上差异无统计学意义(均P>0.05)。结论颈内动脉眼动脉段未破裂动脉瘤血管内治疗的并发症受药物反应、术中操作、血流动力学及治疗材料性质等多方面因素影响。为避免发生严重不良后果,术者应积极预防围手术期并发症的发生。Objective To summarize the complications of endovascular treatment of unruptured aneurysms in the ophthalmic segment of the internal carotid artery,with a preliminary analysis of the occurrence mechanism.Methods The clinical data of 82 patients with unruptured aneurysms in the ophthalmic artery segment of the internal carotid artery were analyzed retrospectively,and the occurrence of complications was recorded and the risk factors were analyzed.Results There were 4 cases of perioperative complications,with an overall complication rate of 4.9%(4/82),including 2 cases of intraoperative vasospasm,1 case of aneurysm rupture and hemorrhage and 1 case of damage to a small local perforating artery.Postoperative follow-up ranged from 3 to 24 months,with a mean follow-up time of 12.7±5.6 months,and none of them developed in-stent stenosis or permanent ocular complications.No stent-related stenosis or permanent ocular complications were observed.There were no statistically significant differences in the incidence of complications associated with endovascular treatment of unruptured aneurysms in the ophthalmic segment of the internal carotid artery based on such factors as patient gender,age,hypertension,diabetes,hyperlipidemia,aneurysm size,and aneurysm morphology(all P>0.05).Conclusions Complications of endovascular treatment for aneurysms in the ophthalmic artery segment of the internal carotid artery are influenced by factors such as drug reactions,intraoperative procedures,hemodynamics,and the nature of treatment materials.To prevent serious adverse consequences,surgeons should actively prevent perioperative complications.

关 键 词：颅内动脉瘤 眼动脉段 血管内治疗 并发症 

分 类 号：R651.12[医药卫生—外科学]