[1]杜世伟,李静伟,陈 健,等.微导管复合塑形在弹簧圈栓塞伴有胚胎型大脑后动脉的破裂后交通动脉瘤术中的应用 [J].介入放射学杂志,2018,27(06):495-499.
 DU Shiwei,LI Jingwei,CHEN Jian,et al.Application of multiple shaping microcatheter in coil embolization for ruptured posterior communicating artery aneurysms associated with embryonic type of posterior cerebral artery [J].journal interventional radiology,2018,27(06):495-499.
点击复制

微导管复合塑形在弹簧圈栓塞伴有胚胎型大脑后动脉的破裂后交通动脉瘤术中的应用 
()

PDF下载中关闭

分享到:

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

卷:
27
期数:
2018年06期
页码:
495-499
栏目:
神经介入
出版日期:
2018-06-25

文章信息/Info

Title:
Application of multiple shaping microcatheter in coil embolization for ruptured posterior communicating artery aneurysms associated with embryonic type of posterior cerebral artery
作者:
杜世伟 李静伟 陈 健 刘 洋 孙力泳 李桂林 张鸿祺
Author(s):
DU Shiwei LI Jingwei CHEN Jian LIU Yang SUN Liyong LI Guilin ZHANG Hongqi
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
关键词:
【关键词】 微导管塑形 后交通动脉瘤 胚胎型大脑后动脉 弹簧圈栓塞
文献标志码:
A
摘要:
【摘要】 目的 探讨微导管复合塑形在单纯弹簧圈栓塞伴有胚胎型大脑后动脉(fPCA)的破裂后交通动脉瘤(PCoAA)术中的安全性和有效性。方法 回顾性分析2015年6月至2016年12月首都医科大学宣武医院采用微导管复合塑形、单纯弹簧圈栓塞治疗的51例伴有fPCA的中小型破裂PCoAA患者临床资料。评价术中微导管塑形准确性、微导管塑形稳定性、栓塞操作相关并发症、动脉瘤栓塞程度和后交通动脉保留程度、随访时神经功能恢复情况。结果 51例51枚伴有fPCA的破裂PCoAA均通过微导管复合塑形技术成功完成单纯弹簧圈栓塞。术后即刻血管造影显示瘤体完全栓塞43例(84.3%),瘤颈残留8例(15.7%);后交通动脉均保留,49例血流无影响,2例部分影响。微导管塑形准确率为90.2%,其中微导管直接推送到位36例,回拉到位11例,导丝导引到位4例;栓塞中88.2%微导管位置稳定。仅1例术中发生破裂再出血。随访6~24个月显示,改良Rankin 量表(mRS)评分≤2分48例(94.1%),3例(5.9%)预后不良,无患者死亡。术后6个月血管复查造影显示,Raymond 1级41枚(80.4%),2级8枚(15.7%),3级2枚(3.9%)。结论 单纯弹簧圈栓塞治疗伴有fPCA的急性期中小型破裂PCoAA术中应用微导管复合塑形技术,可使栓塞过程更稳定和安全,取得了满意效果。

参考文献/References:

[1] Matsumura H, Kato N, Fujiwara Y, et al. Endovascular treatments for posterior cerebral artery aneurysms and vascular insufficiency of fetal- type circulation after parent artery occlusion[J]. J Clin Neurosci, 2016, 32: 41- 46.
[2] Daou B, Valle- Giler EP, Chalouhi N, et al. Patency of the posterior communicating artery following treatment with the Pipeline Embolization Device[J]. J Neurosurg, 2017, 126: 564- 569.
[3] Vedantam A, Rao VY, Shaltoni HM, et al. Incidence and clinical implications of carotid branch occlusion following treatment of internal carotid artery aneurysms with the pipeline embolization device[J]. Neurosurgery, 2015, 76: 173- 178.
[4] Kan P, Duckworth E, Puri A, et al. Treatment failure of fetal posterior communicating artery aneurysms with the pipeline embolization device[J]. J Neurointerv Surg, 2016, 8: 945- 948.
[5] Nakano Y, Saito T, Yamamoto J, et al. Surgical treatment for a ruptured true posterior communicating artery aneurysm arising on the fetal- type posterior communicating artery: two case reports and review of the literature[J]. J UOEH, 2011, 33: 303- 312.
[6] Chen Z, Niu Y, Tang J, et al. Endovascular treatment of posterior communicating artery aneurysms in the presence of the fetal variant of posterior cerebral artery[J]. Interv Neuroradiol, 2015, 21: 456- 461.
[7] Lü X, Li Y, Yang X, et al. Potential proneness of fetal- type posterior cerebral artery to vascular insufficiency in parent vessel occlusion of distal posterior cerebral artery aneurysms[J]. J Neurosurg, 2012, 117: 284- 287.
[8] Yoon PH, Lee JW, Lee YH, et al. Dual microcatheter coil embolization of acutely ruptured wide- necked intracranial aneurysms[J]. Interv Neuroradiol, 2017, 23: 477- 484.
[9] 李 立, 李天晓, 薛绛宇, 等. 单纯弹簧圈栓塞治疗颅内微小动脉瘤[J]. 中华介入放射学电子杂志, 2015, 3: 60- 62.
[10] 彭 亚, 宣井岗, 陈荣华, 等. 血管内栓塞治疗颅内破裂微小动脉瘤的疗效分析[J]. 中国脑血管病杂志, 2013, 10: 13- 17.
[11] 刘 伟, 郭庆东, 付洛安, 等. 微导管塑形技术治疗颈内动脉-后交通动脉瘤[J]. 中华神经外科疾病研究杂志, 2013, 12: 362- 363.
[12] Bisaria KK. Anomalies of the posterior communicating artery and their potential clinical significance[J]. J Neurosurg, 1984, 60: 572- 576.
[13] Bechan RS, Sprengers ME, Majoie CB, et al. Stent- assisted coil embolization of intracranial aneurysms: complications in acutely ruptured versus unruptured aneurysms[J]. AJNR Am J Neuroradiol, 2016, 37: 502- 507.
[14] Namba K, Higaki A, Kaneko N, et al. Microcatheter shaping for intracranial aneurysm coiling using the 3- dimensional printing rapid prototyping technology: preliminary result in the first 10 consecutive cases[J]. World Neurosurg, 2015, 84: 178- 186.
[15] Li H, Guan J, Liu J, et al. Treatment of acutely ruptured wide- necked intracranial aneurysms using self- expanding stent[J]. Int J Clin Exp Med, 2015, 8: 1259- 1264.
[16] Kim S, Choi JH, Kang M, et al. Safety and efficacy of intravenous tirofiban as antiplatelet premedication for stent- assisted coiling in acutely ruptured intracranial aneurysms[J]. AJNR Am J Neuroradiol, 2016, 37: 508- 514.
[17] Li C, Li Y. Stent- assisted coiling of ruptured wide- necked intracranial aneurysms[J]. Interv Neuroradiol, 2013, 19: 283- 288.
[18] He W, Hauptman J, Pasupuleti L, et al. True posterior communicating artery aneurysms: are they more prone to rupture? A biomorphometric analysis[J]. J Neurosurg, 2010, 112: 611- 615.
[19] 徐 超, 王 波, 韩建一, 等. 3D打印辅助微导管塑形在颅内动脉瘤栓塞术中应用[J]. 介入放射学杂志, 2017, 26: 1- 5.

相似文献/References:

[1]王舒婷,虞希祥,乔彬彬,等.早期血管内栓塞术治疗破裂性后交通动脉瘤中远期效果分析[J].介入放射学杂志,2015,(10):843.
 WANG Shu- ting,YU Xi- xiang,QIAO Bin- bin,et al.Early endovascular embolization treatment for the ruptured posterior communicating artery aneurysm: analysis of the mid- term and long- term effects[J].journal interventional radiology,2015,(06):843.
[2]符传艺,陈健龙,张茂,等.介入栓塞与显微手术夹闭治疗后交通动脉瘤伴急性脑积水效果比较[J].介入放射学杂志,2016,(06):473.
 FU Chuan-yi,CHEN Jian-long,ZHANG Mao,et al.Interventional embolization and microsurgical clipping for the treatment of posterior communicating artery aneurysm complicated by acute hydrocephalus: comparison of therapeutic effect[J].journal interventional radiology,2016,(06):473.

备注/Memo

备注/Memo:
(收稿日期:2017-11-29)
(本文编辑:边 佶)
更新日期/Last Update: 2018-06-09