血管内治疗后循环动脉瘤(附24例分析)

Endovascular treatment of posterior circulation cerebral aneurysms:analysis of 24 cases

目的总结后循环动脉瘤的血管内治疗经验。方法回顾性分析采用血管内栓塞治疗24例后循环动脉瘤的临床资料。入院时Hunt-Hess分级:0级3例,Ⅰ级8例,Ⅱ级6例,Ⅲ级5例,Ⅳ级2例。支架辅助弹簧圈栓塞4例,单纯弹簧圈栓塞20例。结果动脉瘤达致密栓塞(99%～100%)13例,大部分栓塞(90%～98%)8例,部分栓塞(<90%)3例。随访6～22个月,平均9.2个月;GOS5分16例,4分5例,3分2例,2分1例,无再出血发生。结论血管内栓塞是后循环动脉瘤安全而有效的治疗方法。

Objective To review the clinical experiences for endovascular treatment for posterior circulation cerebral aneurysms. Methods Clinical data of 24 patients with posterior circulation aneurysms treated by endovascular embolization were analyzed retrospectively. Hunt-Hess grade on admission was grade 0 in 3 patients, grade Ⅰ in 8, grade Ⅱ in 6, grade Ⅲ in 5, and grade Ⅳ in 2. Four patients were treated with stent-assisted coil embolization, while the other 20 patients with coil embolization. Results Complete occlusion （99%-100%） was achieved in 13 cases, nearly complete occlusion （90%-98%） in 8 and partial occlusion （〈 90%） in 3. The mean follow-up period was 9.2 months （range 6-22 months）. The GOS score was 5 in 16 cases, 4 in 5, 3 in 2 and 2 in 1. No postoperative hemorrhage occurred. Conclusion Endovascular embolization is an effective and safe technique for the treatment of posterior circulation aneurysms.