血管内支架治疗椎动脉梭形动脉瘤

Endovascular treatment of fusiform aneurysms of vertebral artery using stents

目的探讨血管内支架治疗颅内椎动脉梭形动脉瘤的临床效果。方法回顾血管内支架治疗的23例椎动脉瘤患者（12例破裂，11例未破裂）。临床结果进行GOS评分。结果23例发现24个椎动脉梭形动脉瘤，共放置了25个支架。所有支架均成功释放，19例用弹簧圈栓塞动脉瘤，3例只放置了支架，1例放置了2枚Neuroform支架来覆盖瘤颈。没有发生与操作技术相关的并发症。临床随访22例（96％）恢复良好（GOS=5），1例（4％）由于术中动脉瘤破裂出血而死亡（GOS=1）。结论血管内应用支架是治疗累及小脑后下动脉上、对侧椎动脉发育不好或未破裂的椎动脉梭形动脉瘤的一种有效的治疗方法。

Objective To report clinical outcomes of endovascular treatment of fusiform aneurysms of vertehral artery （VA） using stents. Methods Consecutive 23 cases （ 12 ruptured, 11 unruptured） of vertebral artery fusiforul aneurysms treated with stents were retrospectively reviewed. Their clinical outcomes were graded with Glasgow outcome scale. Results Twenty - five stents were placed in 23 patients for 24 fusiform VA aneurysms. All patients were successfully treated using stents. In 19 patients coil - embolization of the aneurysmal lumen was used. One aneurysm was treated by placement of 2 stents covering the dissection site. There was no technique - related complication. According to the Glasgow Outcome Scale （GOS） , 22 patients（96 % ） had a good recovery, and 1 （4 % ） died due to intraoperative rebleeding. Conclusion Endovaseular therapy using stents may be a useful treatment in patients with fusiform VA aneurysms involving the PICA or hypoplasia of the contralateral VA or unruptured VA aneurysms.