[1]章 杨,陈 力,顾 奕,等.胚胎型大脑后动脉伴发型颈内动脉后交通动脉瘤血管内治疗——单中心经验[J].介入放射学杂志,2020,29(11):1067-1071.
　ZHANG Yang,CHEN Li,GU Yi,et al.Endovascular treatment for the posterior communicating artery aneurysms of the internal carotid artery associated with the fetal posterior cerebral artery： a single center experience[J].journal interventional radiology,2020,29(11):1067-1071.
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胚胎型大脑后动脉伴发型颈内动脉后交通动脉瘤血管内治疗——单中心经验()

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

卷:
29
期数:
2020年11
页码:
1067-1071
栏目:
神经介入
出版日期:
2020-11-25

文章信息/Info

Title:
Endovascular treatment for the posterior communicating artery aneurysms of the internal carotid artery associated with the fetal posterior cerebral artery： a single center experience
作者:
章 杨;  陈 力;  顾 奕;  顾斌贤;  李明华;  王 武
Author(s):
ZHANG Yang; CHEN Li;  GU Yi;  GU Binxian;  LI Minghua;  WANG Wu.
Institute of Diagnostic and Interventional Radiology， Affiliated Sixth People’s Hospital of Shanghai Jiao Tong University， Shanghai 200233， China
关键词:
【关键词】 胚胎型大脑后动脉;  颅内动脉瘤;  血管内治疗;  弹簧圈;  支架
文献标志码:
A
摘要:
【摘要】 目的 探讨胚胎型大脑后动脉（fPCA）伴发型颈内动脉后交通动脉瘤血管内治疗的安全性和有效性。方法 回顾性分析2010 年 12 月至 2018 年 12 月采用血管内弹簧圈栓塞治疗的25 例fPCA伴发型颈内动脉后交通动脉瘤患者临床资料。采用改良Raymond-Roy分类（MRRC）评估动脉瘤即刻治疗和随访结果，改良Rankin量表（mRS）评分评估患者预后。 结果 25 例共25枚fPCA伴发型颈内动脉后交通动脉瘤患者中女22例，破裂出血23例。术后即刻造影显示充分栓塞15例（MRRCⅠ级7例，Ⅱ级8例），不全栓塞10例（Ⅲa级6例，Ⅲb级4例）。DSA随访平均（20.7±20.6）（3～73）个月，除二期支架辅助弹簧圈栓塞治疗3例外，复发4例，其中2例接受支架辅助弹簧圈栓塞再治疗；随访终点显示MRRCⅠ级10例，Ⅱ级10 例，Ⅲb级 4例。临床随访平均（40.1±30.5）（3～117）个月，患者预后均良好（mRS评分0分23例，1分1例）。 结论 血管内弹簧圈栓塞治疗fPCA伴发型颈内动脉后交通动脉瘤安全有效，很多情况下需要支架辅助，且需要长期密切随访。

参考文献/References:

［1］ Molyneux AJ， Birks J， Clarke A， et al. The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms： 18 year follow- up of the UK cohort of the International Subarachnoid Aneurysm Trial（ISAT）［J］. Lancet， 2015， 385： 691- 697.
［2］ Choi HH， Cho YD， Yoo DH， et al. Comparative analysis of coil embolization in posterior and anterior communicating artery aneurysms［J］. J Neurointerv Surg， 2019， 11： 790- 795.
［3］ Cho YD， Lee WJ， Kim KM， et al. Stent- assisted coil emboli- zation of posterior communicating artery aneurysms［J］. AJNR Am J Neuroradiol， 2013， 34： 2171- 2176.
［4］ 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.
［5］ Sanai N， Caldwell N， Englot DJ， et al. Advanced technical skills are required for microsurgical clipping of posterior communicating artery aneurysms in the endovascular era［J］. Neurosurgery， 2012， 71： 285- 294.
［6］ van Raamt AF， Mali WPTM， van Laar PJ， et al. The fetal variant of the circle of Willis and its influence on the cerebral collateral circulation［J］. Cerebrovasc Dis， 2006， 22： 217- 224.
［7］ Hendricks BK， Yoon JS， Yaeger K， et al. Wide- neck aneurysms： systematic review of the neurosurgical literature with a focus on definition and clinical implications［J］. J Neurosurg， 2019， 14： 1- 7.
［8］ Li MH， Li YD， Tan HQ， et al. Contrast- free MRA at 3.0 T for the detection of intracranial aneurysms［J］. Neurology， 2011， 77： 667- 676.
［9］ 王 武， 李明华， 杜倬婴，等． Neuroform3支架在急诊血管内栓塞破裂性颅内宽颈动脉瘤中的应用［J］． 介入放射学杂志， 2009， 18：4- 10．
［10］ 顾斌贤， 李明华， 王 武. 单个弹簧圈栓塞颅内微小动脉瘤的单中心经验［J］. 介入放射学杂志， 2011， 20： 93- 96.
［11］ Endo H， Sato K， Kondo R， et al. Tuberothalamic artery infarctions following coil embolization of ruptured posterior communicating artery aneurysms with posterior communicating artery sacrifice［J］. AJNR Am J Neuroradiol， 2012， 33： 500- 506.
［12］ Mascitelli JR， Moyle H， Oermann EK， et al. An update to the Raymond- Roy occlusion classification of intracranial aneurysms treated with coil embolization［J］. J Neurointerv Surg， 2015， 7： 496- 502.
［13］ Li MH， Gao BL， Fang C， et al. Angiographic follow- up of cerebral aneurysms treated with Guglielmi detachable coils： an analysis of 162 cases with 173 aneurysms［J］. AJNR Am J Neuroradiol， 2006， 27： 1107- 1112.
［14］ Horikoshi T， Akiyama I， Yamagata Z， et al. Magnetic resonance angiographic evidence of sex- linked variations in the circle of willis and the occurrence of cerebral aneurysms［J］. J Neurosurg， 2002， 96： 697- 703.
［15］ Xu Z， Kim BS， Lee KS， et al. Morphological and clinical risk factors for the rupture of posterior communicating artery aneurysms： significance of fetal- type posterior cerebral artery［J］. Neurol Sci， 2019， 40： 2377- 2382.
［16］ Songsaeng D， Geibprasert S， Willinsky R， et al. Impact of anatomical variations of the circle of Willis on the incidence of aneurysms and their recurrence rate following endovascular treatment［J］. Clin Radiol， 2010， 65： 895- 901.
［17］ Kim YJ， Ko JH. Coiling of a recurrent broad- necked posterior communicating aneurysm incorporating a fetal cerebral artery： a technical case report［J］. Interv Neuroradiol， 2015， 21： 44- 49.
［18］ Arjal RK， Zhu T， Zhou Y. The study of fetal- type posterior cerebral circulation on multislice CT angiography and its influence on cerebral ischemic strokes［J］. Clin Imaging， 2014， 38： 221- 225.
［19］ Walcott BP， Stapleton CJ， Choudhri O， et al. Flow diversion for the treatment of intracranial aneurysms［J］. JAMA Neurol， 2016， 73： 1002- 1008.
［20］ Kuhn AL， Dabus G， Kan P， et al. Flow- diverter stents for endo-vascular management of non- fetal posterior communicating artery aneurysms- analysis on aneurysm occlusion， vessel patency， and patient outcome［J］. Interv Neuroradiol， 2018， 24： 363- 374.
［21］ Pujari A， Howard BM， Madaelil TP， et al. Pipeline embolization device treatment of internal carotid artery terminus aneurysms［J］. J Neurointerv Surg， 2019， 11： 485- 488.
［22］ Rinaldo L， Brinjikji W， Cloft H， et al. Effect of fetal posterior circulation on efficacy of flow diversion for treatment of posterior communicating artery aneurysms： a multi- institutional study［J］. World Neurosurg， 2019， 127： e1232- e1236.
［23］ Enriquez- Marulanda A， Ravindran K， Salem MM， et al. Evaluation of radiological features of the posterior communicating artery and their impact on efficacy of saccular aneurysm treatment with the pipeline embolization device： a case series study［J］. World Neu-rosurg， 2019， 125： e998- e1007.
［24］ 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.
［25］ Wallace AN， Kayan Y， Austin MJ， et al. Pipeline embolization of posterior communicating artery aneurysms associated with a fetal origin posterior cerebral artery［J］. Clin Neurol Neurosurg， 2017， 160： 83- 87.
［26］ Roy AK， Howard BM， Haussen DC， et al. Reduced efficacy of the Pipeline embolization device in the treatment of posterior communicating region aneurysms with fetal posterior cerebral artery configuration［J］. Neurosurgery， 2018， 82： 695- 700.
［27］ 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.
［28］ Tsang AC， Fung AM， Tsang FC， et al. Failure of flow diverter treatment of intracranial aneurysms related to the fetal- type posterior communicating artery［J］. Neurointervention， 2015， 10： 60- 66.
［29］ Choi HH， Cho YD， Yoo DH， et al. Impact of fetal- type posterior cerebral artery on recanalization of posterior communicating artery aneurysms after coil embolization： matched- pair case- control study［J］. J Neurointerv Surg， 2020， 12： 783- 787.
［30］ Raper DMS， Rutledge WC， Winkler EA， et al. Y- stent technique for treatment of wide- necked posterior communicating artery aneurysm associated with fetal posterior cerebral artery： technical report［J］. World Neurosurg， 2020， 133： 173- 177.
［31］ Raymond J， Guilbert FO， Weill A， et al. Long- term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils［J］. Stroke， 2003， 34： 1398- 1403.
［32］ Campi A， Ramzi N， Molyneux AJ， et al. Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the international subarachnoid aneurysm trial（ISAT）［J］. Stroke， 2007， 38： 1538- 1544.

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备注/Memo

备注/Memo:
（收稿日期：2020- 06- 25）
（本文编辑：边 佶）
更新日期/Last Update: 2020-11-16