摘要
目的探讨椎动脉夹层动脉瘤(vertebral artery dissecting aneurysm,VADA)的破裂危险因素与临床疗效。方法回顾性研究52例VADA病例资料,其中单纯支架治疗21例,支架辅助弹簧圈治疗20例,闭塞血管9例,保守治疗2例。结果①动脉瘤即刻栓塞程度:完全栓塞21例,部分栓塞23例,无变化8例。②改良Rankin量表评分(modified Rankin scale,mRS):0~2分48例,3~6分4例。③并发症:单纯支架置入出现缺血1例。支架辅助弹簧圈出现缺血2例,出血1例。闭塞血管和保守治疗病人无并发症。④随访。术后3~12个月复查动脉瘤栓塞程度:完全栓塞39例,部分栓塞11例,无变化2例。随访6~60个月mRS:0~2分50例,3~6分2例;复发再治疗2例。性别和动脉瘤最大宽径(maximum width of aneurysm,WA)是VADA破裂的独立危险因素。结论女性和动脉瘤WA与VADA破裂相关。个体化治疗VADA可取得较好临床疗效。
Objective To investigate the risk factors and clinical outcomes of vertebral artery dissecting aneurysm(VADA)rupture.Methods The clinical data of 52 patients with VADA were analyzed retrospectively.Among them,21 patients were treated with stent implantation alone,20 with stent-assisted coil embolization,9 with vessel occlusion,and 2 received conservative treatment.Results①The degree of immediate embolization of aneurysms:complete embolization was achieved in 21 cases,partial embolization in 23,and no change in 8.②The modified Rankin scale(mRS)score was 0-2 points in 48 cases and 3-6 in 4.③Complications:Ischemia occurred after stent implantation alone in 1 case.After stent assisted coiling,ischemia occurred 2 cases,and bleeding in 1 case.The patients with vessel occlusion and conservative treatment had no complications.④Follow up of 3 to 12 months after surgery found that complete embolization was achieved in 39 cases,partial embolization in 11,and no change in 2.Follow-up for 6 to 60 months revealed that mRS scores were 0-2 in 50 cases and 3-6 in 2;recurrence occurred in 2 cases.Gender and the maximum width of aneurysm(WA)were independent risk factors for VADA rupture.Conclusions Women and WA are associated with VADA rupture.Individualized treatment of VADA can achieve better clinical effects.
作者
何科君
李凡滢
梁丰
杨毅兵
郭少雷
黄正松
齐铁伟
He Kejun;Li Fanying;Liang Feng;Yang Yibing;Guo Shaolei;Huang Zhengsong;Qi Tiewei(Department of Neurosurgery,First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510080,China)
出处
《中国微侵袭神经外科杂志》
CAS
2020年第10期445-449,共5页
Chinese Journal of Minimally Invasive Neurosurgery
基金
国家自然科学基金(编号:81802484)
广东省自然科学基金(编号:2018A030313549)
广东省医学科学技术研究基金(编号:A2018067)。
关键词
动脉瘤
夹层
椎动脉破裂
危险因素
临床疗效
aneurysms,dissecting
vertebral artery dissection
risk factors
clinical efficacy
