Onyx胶栓塞治疗颅内末梢型动脉瘤的疗效分析

Onyx embolization for the treatment of peripheral intracranial aneurysms:an efficacy analysis

目的探讨液态栓塞剂Onyx胶治疗颅内末梢型动脉瘤的临床效果。方法前瞻性研究9例颅内末梢型动脉瘤患者(共10个动脉瘤),动脉瘤位于小脑下后动脉远端5个,小脑上动脉远端2个,大脑后动脉瘤远端1个,大脑中动脉远端2个。均采用Onyx胶闭塞近端载瘤动脉及动脉瘤进行治疗,术后随访6～31个月。结果所有患者动脉瘤均完全闭塞。7例患者恢复良好,格拉斯哥预后评分(GOS)为5分;1例患者术前存在左侧肢体偏瘫,术后无变化,GOS为3分;1例患者死亡。出院前复查头部CT,仅1例左顶叶脑梗死,但无明显症状。4例患者术后6个月复查DSA,动脉瘤均不显影。这4例患者无新的神经功能异常,无再出血。结论 Onyx闭塞近端载瘤动脉及动脉瘤,治疗颅内末梢型动脉瘤短期内安全、有效,长期效果需进一步的临床及影像学随访。

Objective To investigate the clinical effect of liquid embolic agent Onyx in the treatment of peripheral intracranial aneurysms. Methods Nine patients with 10 peripheral intracranial anenrysms were studied prospectively. Five aneurysms were in the distal posterior inferior cerebellar artery, two in the distal superior cerebellar artery, one in the distal posterior cerebral artery, and two in the distal middle cerebral artery. All patients were treated with Onyx to occlude their proximal parent arteries and aneurysms. They were followed up for 6 to 31 months. Results The aneurysms were occluded completely in all the patients. Seven patients had a good recovery, and the Glasgow outcome scale （GOS） score was 5. One patient had left extremity paralysis before the procedure and it did not have any change alter the procedure （ GOS 3 ） ; one patient died. Head CT scan was performed before discharge, only one patient showed left parietal lobe infarction, but he did not have obvious symptoms. Four patients were reexamined by DSA at 6 months after the procedure, and the aneurysms did not recurred. Four patients were followed-up clinically. No new neurological dysfunction and rebleeding were observed in all the patients. Conclusion Onyx occlusion of aneurysms and its proximal parent arteries for treatment of peripheral intracranial artery aneurysms is safe and effective. Further clinical and imaging follow-up are needed for long-term resuh.