烟雾病颅内血流相关性动脉瘤的血管内治疗

Endovascular treatment of intracranial aneurysms associated with Moyamoya disease

目的探讨烟雾病患者颅内血流相关性动脉瘤的临床特点及血管内治疗方法。方法回顾性分析11例经全脑血管造影证实的烟雾病合并颅内血流相关性动脉瘤患者的临床表现和血管内栓塞治疗方法。结果 11例中7例表现为颅内出血,4例表现为缺血症状;9个动脉瘤位于Willis环周围,1个位于大脑后动脉顶枕支,1个位于脉络膜后内侧动脉;11个动脉瘤除1例外周型动脉瘤因超选困难外其余10例均成功行血管内栓塞治疗,随访均获良好疗效。结论烟雾病患者颅内血流相关性动脉瘤可有出血或非动脉瘤性临床表现,此类动脉瘤可分为累及Willis环的主要动脉型动脉瘤和累及侧支为主的外周动脉型动脉瘤;血管内栓塞治疗烟雾病患者的颅内动脉瘤是安全有效的,对外周动脉型动脉瘤可予对症保守治疗。

Objective To explore the clinical characteristics and endovascular treatment of intracranial aneurysms associated with Moyamoya disease.Methods The clinical data of 11 patients with intracranial aneurysm associated with Moyamoya disease confirmed by cerebral angiography were analyzed retrospectively.Results Intracerebral hemorrhage presented in 7 cases and ischemia in 4 cases;9 aneurysms located around the Willis circle,1 located at parieto-occipital branch of posterior cerebral artery,and 1 located at medial posterior choroical artery.Ten aneurysms were successfully embolized except that 1 case distal to the Willis circle failed to be superselected.All patients had excellent clinical outcome.Conclusion The intracranial aneurysms associated with Moyamoya disease may result in intracranial hemorrhage or non-aneurysmal manifestations.The majority of aneurysm can be treated by endovascular treatment and the conservative treatment is recommended for distal aneurysms.