[1]杨 杰,管 生,徐浩文,等.眼动脉段动脉瘤血管内栓塞治疗方法探讨[J].介入放射学杂志,2016,(09):750-754.
 YANG Jie,GUAN Sheng,XU Hao- wen,et al.Discussion on the endovascular embolization treatment of ophthalmic segment aneurysms[J].journal interventional radiology,2016,(09):750-754.
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眼动脉段动脉瘤血管内栓塞治疗方法探讨 ()

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

卷:
期数:
2016年09期
页码:
750-754
栏目:
神经介入
出版日期:
2016-09-25

文章信息/Info

Title:
Discussion on the endovascular embolization treatment of ophthalmic segment aneurysms
作者:
杨 杰 管 生 徐浩文 郭新宾 范 锋 陈 振 李冬冬 刘 朝 王子博 权 涛
Author(s):
YANG Jie GUAN Sheng XU Hao- wen GUO Xin- bin FAN Feng CHEN Zhen LI Dong- dong LIU Chao WANG Zi- bo QUAN Tao
Department of Neurointervention, First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province 450052, China
关键词:
【关键词】 眼动脉段动脉瘤 血管内栓塞 治疗方法
文献标志码:
A
摘要:
【摘要】 目的 探讨颈内动脉眼动脉段动脉瘤血管内栓塞治疗方法及技术要点。方法 回顾性分析2012年5月至2015年4月郑州大学第一附属医院采用血管内栓塞术治疗48例眼动脉段动脉瘤患者影像及临床资料、治疗效果及随访结果,探讨治疗方法及技术要点。结果 48例患者49枚动脉瘤均栓塞成功,其中单纯弹簧圈栓塞17枚(双微导管3枚),球囊辅助栓塞2枚,支架辅助栓塞28枚(Leo支架3枚,Lvis支架5枚,Enterprise支架14枚,Solatire AB支架6枚),Willis覆膜支架隔绝1枚,Pipeline密网支架植入1枚。术后即刻DSA造影显示,Raymond栓塞分级Ⅰ级34枚(69%),Ⅱ级9枚(18%),Ⅲ级6枚(13%)。术中发生支架内血栓形成2例。48例均达到临床治愈,出院时改良Rankin 量表(mRS)评分0分44例,1分2例,4分2例(该2例治疗前≥4分);出院后3个月至1年mRS评分0分46例,2分1例,4分1例,均无新发神经功能障碍及出血。20例DSA随访1~21个月,18例痊愈,1例明显好转, 1例明显复发,再次手术致密栓塞。结论 血管内栓塞治疗眼动脉段动脉瘤是一种微创、安全有效的方法,选择不同栓塞技巧是保证手术成功、减少术后并发症、提高治愈率的关键。

参考文献/References:

[1] 邱教学, 刘一之, 倪才方, 等. 血管内治疗颈内动脉眼动脉段动脉瘤23例临床分析[J]. 介入放射学杂志, 2014, 23: 376- 380.
[2] 张世明, 徐 峰, 惠品晶, 等. 眼动脉段颈内动脉巨大动脉瘤的手术治疗[J]. 中华神经外科杂志, 2006, 22: 473- 475.
[3] Yadla S, Campbell PG, Grobelny B, et al. Open and endovascular treatment of unruptured carotid- ophthalmic aneurysms: clinical and radiographic outcomes[J]. Neurosurgery, 2011, 68: 1434- 1443.
[4] Kang HJ, Lee YS, Suh SJ, et al. A ruptured aneurysm at the infraoptic azygous anterior cerebral artery with the contralateral internal carotid artery agenesis treated by Y- stent assisted coil embolization[J]. J Cerebrovasc Endovasc Neurosurg, 2012, 14: 237- 242.
[5] Sengupta RP, Gryspeerdt GL, Hankinson J. Carotid- ophthalmic aneurysms[J]. J Neurol Neurosurg Psychiatry, 1976, 39: 837- 853.
[6] Wang Y, Li Y, Jiang C, et al. Endovascular treatment of paraclinoid aneurysms: 142 aneurysms in one centre[J]. J Neurointerv Surg, 2013, 5: 552- 556.
[7] Wiebers DO, Whisnant JP, Huston J, et al. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment[J]. Lancet, 2003, 362: 103- 110.
[8] Yeon JY, Hong SC, Kim JS, et al. Unruptured non- branching site aneurysms located on the anterior(dorsal) wall of the supraclinoid internal carotid artery: aneurysmal characteristics and outcomes following endovascular treatment[J]. Acta Neurochir (Wien), 2012, 154: 2163- 2171.
[9] Ogilvy CS, Natarajan SK, Jahshan S, et al. Stent- assisted coiling of paraclinoid aneurysms: risks and effectiveness[J]. J Neurointerv Surg, 2011, 3: 14- 20.
[10] Roy D, Raymond J, Bouthillier A, et al. Endovascular treatment of ophthalmic segment aneurysms with Guglielmi detachable coils[J]. AJNR Am J Neuroradiol, 1997, 18: 1207- 1215.
[11] Ferrell AS, Lessne ML, Alexander MJ, et al. Visual complications after stent- assisted endovascular embolization of paraophthalmic and suprasellar variant superior hypophyseal aneurysms: the Duke Cerebrovascular Center experience in 57 patients[J]. World Neurosurg, 2012, 78: 289- 294.
[12] Lanzino G, Crobeddu E, Cloft HJ, et al. Efficacy and safety of flow diversion for paraclinoid aneurysms: a matched- pair analysis compared with standard endovascular approaches[J]. AJNR Am J Neuroradiol, 2012, 33: 2158- 2161.
[13] Chalouhi N, Tjoumakaris S, Starke RM, et al. Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms[J]. Stroke, 2013, 44: 2150- 2154.
[14] Durst CR, Starke RM, Gaughen J, et al. Vision outcomes and major complications after endovascular coil embolization of ophthalmic segment aneurysms[J]. AJNR Am J Neuroradiol, 2014, 35: 2140- 2145.

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备注/Memo

备注/Memo:
(收稿日期:2015-10-24)
(本文编辑:边 佶)
更新日期/Last Update: 2016-09-19