摘要
目的分析未破裂椎－基底动脉夹层动脉瘤的临床特点及不同血管内治疗技术的效果。方法回顾性分析北京市天坛医院神经介入科2012年1月至2016年12月连续160例患者（175个未破裂椎－基底动脉夹层动脉瘤）的临床资料。175个动脉瘤均行血管内治疗，其中支架辅助弹簧圈栓塞115个，单纯支架成形27个，血流导向装置置入21个，动脉瘤栓塞＋载瘤动脉闭塞12个。术后行影像学及临床随访。结果头痛包括颈枕部痛（43.1%）是最常见的临床表现。围手术期并发症发生率3.75%（6/160），无术中出血病例，无死亡病例。113个动脉瘤影像学随访（10±7）个月。71个支架辅助弹簧圈栓塞动脉瘤中，62个治愈，9个复发；19个单纯支架成型治疗的动脉瘤，4个治愈，11个好转，2个稳定，2个复发；15个行血流导向装置治疗的动脉瘤，4个治愈，11个好转；8个载瘤动脉闭塞的动脉瘤，8个均治愈。144例患者临床随访（17±17）个月，随访改良Rankin量表（mRS）评分：0～2分140例，3～6分4例。结论未破裂椎－基底动脉夹层动脉瘤患者临床表现复杂，头痛是最常见的临床症状。血管内治疗未破裂椎－基底动脉夹层动脉瘤方法多样，临床总体治疗效果良好。选择治疗方法时应遵循个体化的原则。
ObjectiveTo analyze the clinical characteristics, clinical effect and follow-up outcome of the different endovascular treatment techniques in the treatment of unruptured vertebrobasilar dissecting aneurysms （VBDAs）. MethodsThe clinical data of 160 consecutive patients （175VBDAs） from January 2012 to December 2016 in Beijing Tiantan hospital were retrospectively analyzed.All of the 175 aneurysms were treated with endovascular embolization, including 115 stent-assisted coils, 27 simple stents, 21 blood flow diverting devices, and 12 parent arteries occlusion.The imaging and clinical follow-up were performed after the operation.ResultsHeadache including cervical-occipital pain（43.1%）was the most common clinical manifestation.The incidence of perioperative complications was 3.75%, no intraoperative bleeding and no deaths.The imaging findings of 113 aneurysms were followed up for （9.9±7.3） months.Of the 71 stent-assisted coils, 62 recovered well and 9 relapsed; of the 19 aneurysms treated with simple stent, 4 recovered well, 11 improved, 2 stable and 2 relapsed; of the 15 aneurysms treated by the blood flow diverting devices, 4 recovered and 11 improved; all of the 8 aneurysms with parent arteries occlusion recovered well.A total of 144 patients were follow-up （17.3±16.6） months by the Modified Rankin Scale（mRS） score： 140 patients were 0-2 score and 4 patients were 3-6 score.ConclusionsThe clinical manifestations of the unruptured VBDAs are complex, and the headache is the most common clinical symptom.Endovascular treatment for the treatment of unruptured VBDAs is safe and feasible.The principle of individualization should be followed during embolization.
作者
马宁
张宝瑞
冯欣
王璐瑶
彭飞
刘爱华
Ma Ning;Zhang Baorui;Feng Xin;Wang Luyao;Peng Fei;Liu Aihua(Department of lnterventional Neuroradiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100050,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第27期2176-2179,共4页
National Medical Journal of China
基金
国家自然科学基金（81771233）
关键词
夹层动脉瘤
基底动脉
支架
栓塞
治疗性
Aneurysm
dissecting
Basilar artery
Stents
Embolization
theatment
