摘要
目的:总结出血性椎动脉夹层动脉瘤(ruptured vertebral dissecting aneurysms,RVDAs)的诊断和血管内治疗经验,探讨其血管内治疗方案的选择及疗效。方法:2006年3月至2008年3月我院采用血管内介入治疗RVDAs40例,其中内孤立术9例,支架辅助微弹簧圈栓塞20例,双支架置入4例,覆膜支架置入7例。结果:39例患者随访3～24个月,平均12.4个月,临床症状均不同程度改善,无再出血。9例行内孤立术患者闭塞效果确切。支架辅助微弹簧圈栓塞的20例患者中,11例致密填塞者夹层未见显影;7例支架辅助微弹簧圈大部填塞患者,5例夹层无改变,2例瘤体缩小;2例疏松填塞患者,瘤体缩小。4例行双支架置入者,DSA随访的2例示夹层病变局部血管管腔扩大,瘤体较术前缩小。7例行覆膜支架置入术,其中6例置入成功,夹层病变未见显影,支架通畅;1例因动脉迂曲,支架未能成功置入,术后1 d患者发生夹层动脉瘤再次破裂出血死亡。结论:血管内治疗是RVDAs的理想的选择,治疗方案应根据临床症状、夹层动脉瘤的部位、形态及其与周围分支的关系而确定。
Objective：To summarize the diagnosis and endovascular treatment experiences in patients with ruptured vertebral dissec- ting aneurysms（ RVDAs ）. Explore and discuss the choice and effect of endovascular treatment, nethods：Endovascular interventional procedures were adopted in 40 RVDAs patients from March 2006 to March 2010,including simple embolization with coils in 9, stent-coil embolization in 20, double stent implantation alone in 4, and covered stents implantation in 7. Results ： Thirty-nine cases were followed- up from 3 months to 24 months （average 12.4 months）. Clinical symptoms were improved to different extents in all cases,and no hem- orrhage recurred. Stable occlusion was demonstrated in 9 patients who were embolized with coils. Among the 20 patients with stent-coil embolization, 11 of them showed disappearance of all the aneurysms. No regrowth of the aneurysms was found in partially packed aneu- rysms. In the 4 cases treated by stent implantation alone,recurrences were found in 2 cases and an additional stent was implanted. The 6 cases treated by covered stent showed no recanalization of the aneurysms and the patency of the parent arteries. One case died. Con- clusion：Endovascular treatment is the ideal choice of treating RVDAs. Therapeutic strategies depend on clinical symptoms, the loca- tion, configuration of the dissection, and the relationship of vital branches around.
出处
《川北医学院学报》
CAS
2013年第3期217-221,共5页
Journal of North Sichuan Medical College
基金
国家自然科学基金资助项目(81271277)
关键词
动脉瘤
夹层
椎动脉
血管内治疗
支架
Intracranial Aneurysm
Dissecting aneurysm
Vertebral artery
Endovascular Treatment
Stent graft
