[1]谭华桥,周育苗,方 淳,等.血管内介入治疗周围型颅内动脉瘤17例[J].介入放射学杂志,2016,(04):279-284.
 TAN Hua- qiao,ZHOU Yu- miao,FANG Chun,et al.Endovascular treatment of peripheral intracranial aneurysm: report of 17 patients[J].journal interventional radiology,2016,(04):279-284.
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血管内介入治疗周围型颅内动脉瘤17例 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2016年04期
页码:
279-284
栏目:
神经介入
出版日期:
2016-04-25

文章信息/Info

Title:
Endovascular treatment of peripheral intracranial aneurysm: report of 17 patients
作者:
谭华桥 周育苗 方 淳 朱悦琦 李永东 李明华 罗祖炎
Author(s):
TAN Hua- qiao ZHOU Yu- miao FANG Chun ZHU Yue- qi LI Yong- dong LI Ming- hua LUO Zu- yan
Department of Interventional Radiology, Affiliated Tongji Hospital, Tongji University, Shanghai 200065, China
关键词:
【关键词】 周围型颅内动脉瘤 血管内介入治疗 蛛网膜下腔出血
文献标志码:
A
摘要:
【摘要】 目的 报道血管内介入治疗周围型颅内动脉瘤的效果和临床经验,探讨介入治疗策略。 方法 2010年1月至2015年12月采用血管内介入术治疗17 例周围型颅内动脉瘤(男7例,女10例,平均年龄52.1岁),1例为偶然发现的血流相关性动脉瘤,16例为蛛网膜下腔出血,其中3例伴有脑实质内血肿,1例伴发脑室内出血,1例为偶然发现的其它部位动脉瘤破裂。动脉瘤位于小脑上动脉1例,脉络膜前动脉1例,大脑前动脉8例,小脑后下动脉4例,大脑后动脉3例。囊性动脉瘤9例,夹层动脉瘤7例,假性动脉瘤1例。所有动脉瘤均为小动脉瘤,2例梭形夹层动脉瘤缺乏明确瘤颈,15例为窄颈,其中5例体-颈比≤2,10例体-颈比>2。结果 血管内介入治疗技术成功率为100%。术后即刻,11例弹簧圈栓塞患者中7例囊状动脉瘤完全闭塞,1例囊状动脉瘤和2例夹层囊状动脉瘤不全闭塞,1例夹层囊状动脉瘤瘤颈残留;6例动脉瘤和载瘤动脉同时栓塞患者中5例完全闭塞,1例不全闭塞、载瘤动脉部分闭塞。术后3例出现神经功能缺损,其他患者无新发神经功能缺损。出院时改良Rankin 量表(mRS)评分为0分14例,2分1例,4分2例。术后6~9个月血管造影和临床随访显示,11例弹簧圈栓塞患者中7例动脉瘤仍保持完全闭塞,3例不全闭塞,1例瘤颈残留患者复发;6例动脉瘤和载瘤动脉同时栓塞患者中5例动脉瘤仍保持完全闭塞,1例载瘤动脉再通。末次随访显示14例保持mRS评分0分,1例保持4分不变,2例mRS评分有明显改善。结论 对于外科手术治疗较困难的周围型颅内动脉瘤,血管内介入治疗是一种安全有效的治疗方法。选择何种血管内介入治疗策略取决于动脉瘤部位、性质、形态、血管入路迂曲程度和载瘤动脉供血区功能重要程度。

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备注/Memo

备注/Memo:
(收稿日期:2015-11-12)
(本文编辑:边 佶)
更新日期/Last Update: 2016-04-21