[1]李钊硕,李天晓,薛绛宇,等.介入治疗基底动脉夹层动脉瘤效果分析 【[J].介入放射学杂志,2016,(06):478-482.
　LI Zhao-shuo,LI Tian-xiao,XUE Jiang-yu,et al.Analysis of curative effect of endovascular interventional treatment for basilar artery dissecting aneurysms [J].journal interventional radiology,2016,(06):478-482.
点击复制

介入治疗基底动脉夹层动脉瘤效果分析 【()

PDF下载中关闭

分享到：

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

卷:
期数:
2016年06期
页码:
478-482
栏目:
神经介入
出版日期:
2016-06-25

文章信息/Info

Title:
Analysis of curative effect of endovascular interventional treatment for basilar artery dissecting aneurysms
作者:
李钊硕; 李天晓; 薛绛宇; 冯光; 王子亮; 白卫星; 朱良付; 赵同源; 许岗勤; 杨博文
Author(s):
LI Zhao-shuo;  LI Tian-xiao;  XUE Jiang-yu;  FENG Guang;  WANG Zi-liang;  BAI Wei-xing;  ZHU Liang-fu;  ZHAO Tong-yuan;  XU Gang-qin;  YANG Bo-wen
Interventional Treatment Center of Cerebrovascular Diseases, Peoples Hospital of Zhengzhou University, Henan Provincial Interventional Treatment Center, Henan Provincial Prevention and Treatment Center of Cerebrovascular Diseases, Zhengzhou, Henan Province 450003, China
关键词:
【关键词】基底动脉夹层;  动脉瘤;  支架;  血管内介入治疗
文献标志码:
A
摘要:
摘要】目的评价血管内介入治疗基底动脉夹层动脉瘤的安全性、有效性。 方法回顾性分析2009年1月至2015年4月在我院接受血管内介入治疗的26例基底动脉夹层动脉瘤患者。按瘤体大小分为大型-巨大型组和中小型组,比较两组患者治疗效果。记录并发症和随访情况。 结果26例基底动脉夹层动脉瘤患者均获得成功治疗,其中接受单纯支架植入9例,支架植入结合弹簧圈栓塞17例。围手术期共发生5例并发症,其中3例为后循环梗死(单纯支架组1例,支架结合弹簧圈组2例),2例为小脑出血(均发生于支架结合弹簧圈组),随后4例恢复良好出院,1例支架内急性血栓形成死亡。22例患者获得DSA随访,结果显示12例改善,7例稳定,3例复发(2例有新发症状)。亚组分析显示单纯支架组并发症发生率低于支架结合弹簧圈组,两组远期疗效相当；大型-巨大型组并发症发生率和严重残死率均高于中小型组,差异均有统计学意义(P=0.020,Z=3.247)。 结论血管内介入治疗基底动脉夹层动脉瘤有较好的安全性和有效性。多重支架技术仍然是目前优先推荐的术式,需依据不同病变特点确定是否使用弹簧圈辅助。大型和巨大型夹层动脉瘤治疗仍然棘手,需要进一步研究。

参考文献/References:

 

［1 ］Choi IS, David C. Giant intracranial aneurysms: development, clinical presentation and treatment ［J ］. Eur J Radiol, 2003, 46: 178-194.

［2 ］Schievink WI. Spontaneous dissection of the carotid and vertebral arteries ［J ］. N Engl J Med, 2001, 344: 898-906.

［3 ］L ü X, Jiang C, Li Y, et al. Clinical outcomes of ruptured and unruptured vertebral artery-posterior inferior cerebellar artery complex dissecting aneurysms after endovascular embolization ［J ］. AJNR Am J Neuroradiol, 2010, 31: 1232-1235.

［4 ］辛涛, 贺西亮, 高述礼, 等. 多支架技术治疗椎- 基底动脉巨大夹层动脉瘤疗效分析［J ］. 介入放射学杂志, 2012, 21 ： 976-980.

［5 ］Ng P, Khangure MS, Phatouros CC, et al. Endovascular treatment of intracranial aneurysms with Guglielmi detachable coils: analysis of midterm angiographic and clinical outcomes ［J ］. Stroke, 2002, 33: 210-217.

［6 ］Geremia G, Haklin M, Brennecke L. Embolization of experimentally created aneurysms with intravascular stent devices ［J ］. AJNR Am J Neuroradiol, 1994, 15: 1223-1231.

［7 ］Hopkins LN, Budny JL. Complications of intracranial bypass for vertebrobasilar insufficiency ［J ］. J Neurosurg, 1989, 70: 207-211.

［8 ］赵文元, 刘建民, 许奕, 等. 颅内出血性椎动脉夹层的治疗［J ］. 中华神经外科杂志, 2007, 23 ： 577-580.

［9 ］Wakhloo AK, Mandell J, Gounis MJ, et al. Stent-assisted reconstructive endovascular repair of cranial fusiform atherosclerotic and dissecting aneurysms: long-term clinical and angiographic follow-up ［J ］. Stroke, 2008, 39: 3288-3296.

［10 ］Kallmes DF, Hanel R, Lopes D, et al. International retrospective study of the pipeline embolization device: a multicenter aneurysm treatment study ［J ］. AJNR Am J Neuroradiol, 2015, 36: 108-115.

［11 ］Siddiqui AH, Abla AA, Kan P, et al. Panacea or problem: flow diverters in the treatment of symptomatic large or giant fusiform vertebrobasilar aneurysms ［J ］. J Neurosurg, 2012, 116: 1258-1266.

［12 ］Meckel S, McAuliffe W, Fiorella D, et al. Endovascular treatment of complex aneurysms at the vertebrobasilar junction with flow-diverting stents: initial experience ［J ］. Neurosurgery, 2013, 73: 386-394.

 

相似文献/References:

[1]苏新友,周存升,刘作勤.脑动静脉畸形出血的危险因素[J].介入放射学杂志,2000,(03):185.
[2]郭道芳,刘作勤,唐军,等.烟雾病伴发动脉瘤(附22例报道)[J].介入放射学杂志,2000,(03):139.
[3]陈宏颉,刘峥.经颈动脉途径治疗脑血管病变[J].介入放射学杂志,1998,(01):8.
[4]许奕,刘建民,周晓平,等.电解可脱卸弹簧圈栓塞颅内动脉瘤[J].介入放射学杂志,1999,(02):5.
[5]谭孝华,许日初,莫雪红,等.肾感染致肾血管瘤出血急诊介入治疗一例[J].介入放射学杂志,1999,(03):5.
[6]邢丽,杨进全.脑动静脉畸形介入治疗的配合与护理[J].介入放射学杂志,1996,(04):230.
[7]马永迁,王育波,于金录,等. 血管腔内弹性蛋白酶诱导兔动脉瘤模型制作进展[J].介入放射学杂志,2012,(03):257.
　,,et al.Ｒｅｓｅａｒｃｈ ｐｒｏｇｒｅｓｓ ｉｎ ｔｈｅ ｅｓｔａｂｌｉｓｈｉｎｇ ｏｆ ｉｎｔｒａｌｕｍｉｎａｌ ｅｌａｓｔａｓｅｉｎｄｕｃｅｄ ａｎｅｕｒｙｓｍ ｍｏｄｅｌ ｉｎ ｒａｂｂｉｔｓ [J].journal interventional radiology,2012,(06):257.
[8]杨 帆,王家平,龙 超,等.带膜支架治疗Stanford B型胸主动脉夹层的疗效分析 [J].介入放射学杂志,2015,(03):197.
　YANG Fan,WANG Jia ping,LONG Chao,et al.Evaluation of endovascular covered stent implantation in treating Stanford type B aortic dissection[J].journal interventional radiology,2015,(06):197.
[9]朱国辉,段传志,李西锋,等.小脑动静脉畸形伴发动脉瘤栓塞治疗[J].介入放射学杂志,2015,(05):369.
　ZHU Guo hui,DUAN Chuan zhi,LI Xi feng,et al.Interventional embolization therapy for cerebellar arteriovenous malformations associated with aneurysm [J].journal interventional radiology,2015,(06):369.
[10]张广宁,宋国红,张 冉,等.复合手术治疗颅颈部血管病变4例[J].介入放射学杂志,2015,(10):875.
　SONG Guo- hong,Guang- ning,SONG Guo- hong,et al.Hybrid surgery for the treatment of craniocervical vascular diseases： initial experience of 4 patients ZHANG .[J].journal interventional radiology,2015,(06):875.

备注/Memo

备注/Memo:
(收稿日期：2015-11-26)


(本文编辑：边佶)
更新日期/Last Update: 2016-06-21