血管内栓塞治疗床突旁动脉瘤的临床分析 缪洪平，杨云峰，陈 志，牛 胤 .docVIP

血管内栓塞治疗床突旁动脉瘤的临床分析 缪洪平，杨云峰，陈 志，牛 胤，蒋周阳，唐卫华，朱 刚，林江凯，冯 华 （400038重庆，第三军医大学西南医院神经外科，全军神经外科研究所） [摘要] 目的 探讨床突旁动脉瘤的诊断、血管内栓塞的适应症、方法及并发症的防治。方法 对40例（46个动脉瘤）床突旁动脉瘤患者进行回顾性研究。其中，单纯微弹簧圈栓塞21例，支架辅助微弹簧圈栓塞8例，球囊辅助微弹簧圈栓塞4例。术后进行CT、3D-CTA、MRI和/或3D-DSA随访检查，观察并分析疗效。结果 33例患者（38个动脉瘤）成功栓塞，7例患者放弃治疗。随访35例患者，5例失访。3个月至2年GOS评分，5分27例，4分3例，3分1例，2分1例，1分3例。28例经血管内栓塞治疗的患者未见动脉瘤新生或再通及出血症状发生。7例未治疗的患者中，未破裂的患者4例未发生出血，破裂的患者3例均发生再次出血死亡。结论 血管内栓塞治疗床突旁动脉瘤能有效改善预后，3D-CTA、3D-DSA的应用能为床突旁动脉瘤的诊治、复查提供有效的帮助。 [关键词] 床突旁动脉瘤;血管内栓塞治疗 [中图法分类号] [文献标志码] A Endovascular Embolization Treantment of Paraclinoid Aneurysms Miao Hongping, Yang Yunfeng, Chen Zhi, Niu yin, Jiang Zhouyang, Tang Weihua, Zhu Gang, Lin Jiangkai, Feng Hua(Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China) [Abstract] Objective To analyze the clinical experiences of endovascular treatment of paraclinoid aneurysm. Methods The clinical data of 40 cases of paraclinoid aneurysms(46) undergoing endovascular embolization were retrospectively reviewed. Among the 40 cases, endovascular coil embolization was used in 21, stent-assisted coil embolization was used in 8 , balloon-assisted coil embolization was used in 4 and only observed in 7 cases. Effects of the treatment were analysed, and postoperative follow-up was conducted by CT, 3D-CTA, MRI and/or 3D-DSA. Results Immediate postprocedure angiography showed that total obliteration of aneurysm was achieved in 33 cases (38 aneurysms). 35 cases were followed up by 3D-CTA and/or DSA within 3-48 months. The final clinical outcomes showed GOS of 5 in 27 patients, GOS of 4 in 3, GOS of 3 in 1, GOS of 2 in 1 and GOS of 1 in 3. No recurrence and rebleeding case in 28 cases with endovascular embolization treantment. 3 re-bleeding cases were found in 7 cases with only observation. Conclusion Endovascular therapy is a minimally invasive, safe and effective treatment for paraclinoid aneurysms, which can be proper