颈内动脉床突上段微小动脉瘤的血管内治疗和长期随访

Endovascular Treatment and Long Term Follow up for Supraclinoid Micro aneurysms

目的评价血管内支架辅助弹簧圈栓塞治疗颈内动脉床突上段宽颈微小动脉瘤的稳定性和有效性。资料与方法回顾性分析2006至2008年接受支架辅助弹簧圈栓塞治疗的12例患者的临床资料(共14枚动脉瘤)。根据血管造影表现,分为完全栓塞、次全栓塞和部分栓塞。术后进行长期随访并搜集造影和临床结果。结果所有动脉瘤使用弹簧圈均成功填塞。术后即刻造影显示,12例共14枚动脉瘤中,次全栓塞8枚,部分栓塞6枚。3例弹簧圈部分残留于载瘤动脉,未出现弹簧圈移位及血栓形成。12例均经1～2年随访。随访造影显示动脉瘤完全栓塞。临床随访显示所有患者未出现动脉瘤再次破裂出血及神经系统缺血症状。结论初步结果显示,支架辅助弹簧圈技术栓塞颈内动脉床突上段宽颈微小动脉瘤稳定、有效。长期随访证明次全栓塞者也可发展为完全栓塞。

Objective To evaluate the feasibility and efficacy of Neuroform stent-assisted coiling in the treatment of supraclinoid micro aneurysms.Materials and Methods From 2006 to 2008,12 patients with 14 supraclinoid micro aneurysms underwent stent-assisted coil embolization in our institution.The aneurysms were treated as total,subtotal and partial occlusion according to angiographic findings.Long-term follow-up was performed after the procedure.The angiographic and clinical data were collected.Results All aneurysms were successfully embolized with coils.The initial angiographic results revealed subtotal occlusion in 8 patients and partial occlusion in 6 patients.In 3 cases,the coil partially remain in the parent artery.Coil/stent displacement and acute thrombosis were not occurred.During one to two years follow-up,angiographic results exhibited total occlusion in all patients.The clinical follow-up demonstrated that no rehemorrhage or neurologic symptom of ischemic stroke occurred in any patients.Conclusion The preliminary results demonstrate good efficacy and feasibility of Neuroform stent-assisted coiling in the treatment of supraclinoid micro aneurysms.Subtotal aneurysm occlusion might progress to total occlusion during long term follow up.