椎动脉夹层动脉瘤—附3例报道及文献复习

Vertebral artery dissecting aneurysms:Report of 3 cases and review of the literature

目的 探讨椎动脉(VA)夹层动脉瘤的临床特点、诊断和治疗选择。方法 3例VA夹层动脉瘤均行介入手术治疗,2例行支架植入和可脱性微弹簧圈栓塞,1例行载瘤动脉、动脉瘤球囊闭塞。结合文献分析3例VA夹层动脉瘤的诊疗过程。结果 2例表现为自发性蛛网膜下腔出血,1例表现为眩晕。脑血管造影为2例串珠样、1例形成梭形动脉瘤。2例恢复良好,1例术后死亡。结论 血管内治疗是VA夹层动脉瘤理想的治疗选择。

Objective To investigate the features, diagnosis and the ideal therapy of vertebral dissecting aneurysms. Methods Three vertebral dissecting aneurysms were performed endovascular treatment,2 with stents implantation and embolization, one parental artery and aneurysm occlusion. The course of the diagnosis and treatment were analized correlating with the literature. Results One male, two female, 56-66 years old. 2 presented SAH, one complained of vertigo. The features on DSA: 2 showed pearl and string sign, that was, aneurismal dilation accompanied by proximal and/or distal narrowing; one demonstrated fusiform aneurysm. Two cases recovered well, one died after procedure.Conclusions Endovascular treatment is the ideal choice to treat the vertebral dissecting aneurysms.