血管内治疗椎-基底动脉夹层动脉瘤的疗效分析

摘要

目的：探讨血管内治疗椎-基底动脉夹层动脉瘤的效果。方法回顾性分析北京市海淀医院和首都医科大学宣武医院2013年8月至2014年9月入院治疗的40例椎-基底动脉夹层动脉瘤患者的临床资料，并对其进行临床症状及影像学随访。按治疗方式分为支架辅助弹簧圈栓塞组（ A组，34例）和载瘤动脉闭塞组（B 组，6例），并根据术后1年的临床症状及影像学随访评价疗效。结果术后随访1年，A组患者改善29例（85.3％），稳定1例（2.9％），进展4例（11.8％），4例进展患者死于脑梗死并发症（术后1周至半年）；B组6例患者均较术前改善，未发生颅内出血及缺血事件。结论采用支架辅助弹簧圈栓塞技术和载瘤动脉闭塞技术治疗椎-基底夹层动脉瘤相对安全有效。%Objective To investigate the effect of endovascular treatment of vertebral basilar artery dissecting aneurysms. Methods The clinical data of 40 patients with vertebral basilar artery dissecting aneurysm admitted to Beijing Xuanwu Hospital and Haidian hospital,Capital Medical University from August 2013 to September 2014 were analyzed retrospectively. Their clinical symptoms and imaging were followed up. According to the treatment methods,they were divided into either a stent-assisted coil emboliza-tion group (group A;n = 34)or a parent artery occlusion (group B;n = 6),and according to the clinical symptoms and imaging followed-up,the efficacy was assessed at 1 year after procedure. Results The patients were followed up for 1 year after procedure,29 patients (85. 3%)were improved in group A, 1 (2.9%)was stable,and 4 (11. 8%)deteriorated. All the 4 deteriorated patients died of cerebral infarction complications (at 1 week to 6 months after procedure). The 6 patients in group B were improved compared with before procedure. No intracranial hemorrhage and ischemic events occurred. Conclusion Using the stent-assisted coil embolization technique and the parent artery occlusion technique for the treatment of the vertebral basilar artery dissecting aneurysms are relatively safe and effective.