血管内载瘤动脉近端闭塞在累及小脑后下动脉的椎动脉夹层动脉瘤中的应用

The application of the endovascular distal parent artery occlusion in vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery

目的探讨血管内载瘤动脉近端闭塞在累及小脑后下动脉的椎动脉夹层动脉瘤中的应用价值。方法回顾性分析5例采用血管内载瘤动脉近端闭塞治疗的累及小脑后下动脉的椎动脉夹层动脉瘤患者的临床及随访资料。结果治愈4例，随访6～12个月，无复发及神经功能障碍，1例造影见动脉瘤显影，但是无再出血或神经功能障碍。结论在治疗累及小脑后下动脉的椎动脉夹层动脉瘤急性破裂出血时，血管内载瘤动脉近端闭塞可闭塞夹层动脉瘤，同时又保持小脑后下动脉通畅，是一种较安全、有效的方法。

Objective To investigate the application of endovascular distal parent artery occlusion in vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery. Methods The clinical and follow-up data of 5 patients with vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery who received the endovascular distal parent artery occlusion were retrospectively analyzed. Results Complete occlusion of dissected arterial and aneurysm segments was achieved in 4 patients. After followed up 6 -12 months, angiography showed no recurrence or neurological deficit. Continued filling of the dissected aneurysm was observed in 1 patient＇s follow-up angiography, but without rehaemorrhagia or neurological deficit. Conclusions The endovascular distal parent artery occlusion is a safe and efficient choice for treating vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery, which keeps the posterior inferior cerebellar artery flowing unobstructed while clipping the dissecting aneurysm.