椎基底动脉夹层动脉瘤的介入治疗

Endovascular therapy for intracranial vertibrobasil dissectimng aneurysm

目的总结椎基底动脉夹层动脉瘤的影像学特征、血管内栓塞治疗技巧及结果。方法采用血管内介入治疗椎基底动脉夹层动脉瘤30例，其中支架置入术4例，支架结合弹簧圈栓塞26例。结果椎基底动脉夹层动脉瘤全脑血管造影表现为“线征”、“串珠征”、“双腔征”等，保留载瘤动脉通畅25例（83．3％），术后脑内出血1例（3．3％），无其他并发症出现，26例（86．7％）获5～34个月随访（平均11．2个月），均恢复良好，全组无死亡。结论治疗策略应根据临床症状、夹层动脉瘤的部位、形态及其与周围分支的关系而确定，支架结合弹簧圈治疗椎基底动脉夹层动脉瘤具有微创、安全、效果可靠的优点。

Objective To summarize the radiographic characteristic and endovaseular interventional technique in patients with intraeranial vertibrobasil disseetimng aneurysm. Methods Totally 30 patients of intracranial vertibrobasil dissectimng aneurysm were embolized technique, 26 with stent assisted coiling technique. Results by endovascular therapy, 4 with stent implantation Patency of parent artery was restored in 25 cases （83.3%）, and except 1 ease （3.3%） of postoperative intraeerebral hemorrhage, no other complications occurred. All patients were followed up from 5 months to 34 months （ average 11.2）. All eases recovered well. No ease died in the cohort. Conclusion Intraeranial vertibrobasil disseetimng aneurysm has following angiographic features： string sign, pearl and string sign, and double lumen sign. Therapeutic strategies depend on clinical symptoms, the location, configuration of the dissection, and the relationship of vital branches around. The results suggested that embolization of intraeranial vertibrobasil disseetimng aneurysm with coils is minimally invasive, safe, effective and reliable.