椎动脉颅内段夹层动脉瘤介入治疗.docVIP

椎动脉颅内段夹层动脉瘤介入治疗 　　【摘要】 目的：总结椎动脉颅内段夹层动脉瘤的介入治疗策略及治疗效果。方法：回顾性分析2012年10月-2015年8月徐州医学院附属医院介入科收治的16例颅内椎动脉夹层动脉瘤患者资料，就其介入治疗策略作回顾总结，通过?底旨跤澳匝?管造影及临床随访观察其治疗效果。结果：7例无蛛网膜下腔出血，9例临床表现为自发性蛛网膜下腔出血。采取椎动脉内支架之置入辅助弹簧圈栓塞12例， 2例因夹层累及小脑后下动脉而将支架置于小脑后下动脉内后闭塞动脉瘤，2例采用闭塞载瘤动脉治疗。术后1例因急性脑积水行脑室腹腔分流术。15例恢复良好，死亡1例；6个月后7例DSA随访，未见动脉瘤显影。结论：积极采取保留或闭塞载瘤动脉的介入方法治疗椎动脉颅内段夹层动脉瘤取得较好的临床效果，远期效果需要进一步观察 【关键词】 椎动脉； 夹层动脉瘤； 支架置入； 弹簧圈 Interventional Treatment for Intracranial Vertebral Artery Dissecting Aneurysms/CUI Yan-feng，ZU Mao-heng，GU Yu-ming，et al.//Medical Innovation of China，2016，13（35）：113-117 【Abstract】 Objective：To evaluate the treatment strategies and clinical efficacy of interventional therapy for intracranial vertebral artery dissecting aneurysms.Method：A retrospective analysis was performed of clinical data from 16 patients with intracranial vertebral artery dissecting aneurysms treated in the Department of Interventional Radiology，Xuzhou Medical College Hospital from October 2012 to August 2015.All patients were treated with coil embolization of aneurysms.DSA，CT and clinical follow-up were conducted to observe the therapeutic efficacy of intracranial vertebral artery dissecting aneurysms.Modified RANKIN Scale（mRS） scores at hospital discharge were used to evaluate the prognosis of patients.Result：All 16 cases were successful treated without bleeding complication during the operation.12 aneurysms were treated by stent-assisted coiling，2 aneurysms was treated by stent implanted in PICA and then aneurysm occlusion with coils，2 aneurysms was treated by proximal vertebral artery and aneurysm occlusion with coils.1 case died after operation.An acute hydrocephalus occurred in 1 case after operation and ventriculoperitoneal shunt was performed.During the follow up 1-24 months，there was no recurrence of bleeding and infarction.7 cases were followed up by angiography，DSA showed that 7 aneurysms were disappeared.Conclusion：Interventional treatment of intracranial vertebral artery dissecting aneurysms is f