摘要
目的探讨颅内动脉瘤合并脑动脉狭窄患者的临床症状,我院发病情况及个体综合介入治疗方法。方法本研究针对9例颅内动脉瘤合并脑动脉狭窄的患者进行治疗,其中8例应用血管内介入治疗颅内动脉瘤及脑动脉狭窄;1例开颅行动脉瘤夹闭术,术后择期行脑动脉狭窄支架成形术。结合影像学及随访评估手术效果。结果 9例入组患者均成功完成血管内支架置入术,围手术期期间无手术相关并发症。术后随访有1例血管内再狭窄;2例患者瘤颈处复发。1例动脉瘤夹闭术后择期行血管内支架成形术患者,术后常规服用抗血小板凝集药物,随访期间无颅内出血倾向。其余病例责任血管血流顺畅,支架位置无明显改变,病变血管管径正常;病变血管的分支血管无明显异常、闭塞或狭窄等;动脉瘤瘤体、瘤颈处均无造影剂进入。结论对于颅内动脉瘤伴发脑动脉狭窄的患者,通过仔细的术前评估以及个体化治疗可以显著提高治疗效果。
Objective To investigate the clinical feature, incidence and intervention strategies of the patients with intracranial aneurysm and cerebral artery stenosis. Methods Nine patients with intracranial aneurysm and cerebral artery stenosis were treated. Eight of them used the endovascular method, and another one patient underwent clipping operation of aneurysm first and was performed stenting next. Imageology and follow-up investigation were used to assess the effectiveness of the operations. Results All nine patients were placed stents successfully and without perioperative complications during perioperative period. The results of follow-up investigation showed one case with intravascular restenosis and two cases with tumor recurrence on the neck of tumor. The patient who was performed clipping operation of aneurysm first and stenting next was applied antiplatelet drugs, and intracranial hemorrhage was not happened during the follow-up investigation. For the rest of the cases, the vessels were unobstructed, and the stents were in good shape without collapse, displacement, deformation, and restenosis. The main branches of the vessel had no stenosis or occlusion. There was no contrast agent in the body and neck of aneurysm. Conclusion For patients with intracranial aneurysm accompanied by cerebral artery stenosis, preoperative evaluation and individualized treatment can significantly improve the therapeutic effect.
作者
谢鹏
李瑞岩
冯岩
王洪军
李庆斌
陈明辉
蒿忠飞
李永利
XIE Peng;LI Rui-yan;FENG Yan;WANG Hong-jun;LI Qing-bin;CHEN Ming-hui;HAO Zhong-fei;LI Yong-li(Department of Neurosurgery,The Second Affiliated Hospital of Harbin Medical University,Harbin 150081,China)
出处
《哈尔滨医科大学学报》
CAS
2020年第6期617-620,624,共5页
Journal of Harbin Medical University
关键词
颅内动脉瘤
脑动脉狭窄
动脉瘤栓塞
脑动脉成形术
介入治疗
intracranial aneurysm
cerebral artery stenosis
aneurysm embolization
cerebral artery figuration
endovascular treatment
