椎动脉夹层动脉瘤的血管内治疗

Endovascular treatment of vertebral artery dissecting aneurysms

目的 探讨椎动脉夹层动脉瘤（vertebral artery dissecting aneurysm,VADA）血管内治疗的可行性和疗效.方法 回顾性分析7例接受血管内治疗的VADA患者的临床资料.结果 7例VADA患者均成功进行血管内治疗.以蛛网膜下腔出血起病的2例患者采用动脉瘤和载瘤动脉栓塞术,术后即刻造影显示VADA完全消失;其余5例未破裂VADA患者采用支架辅助弹簧圈栓塞术,术后即刻造影显示2例完全栓塞,3例近全栓塞.患者造影随访均显示VADA未显影,未见复发及出血.结论 VADA的血管内治疗安全可行.

Objective To investigate the feasibility and efficacy of endovaseular treatment of vertebral artery dissecting aneurysms （VADAs）.Methods The clinical data of 7 patients with VADAs underwent endovascular treatment were analyzed retrospectively.Results Seven patients with VADAs successfully received endovascular treatment.Two patients with the onset of subarachnoid hemorrhage were treated with aneurysm embolization and parent artery embolization.Immediate postoperative angiography showed VADAs disappeared completely.The other 5 patients with unruptured VADAs were treated with stent-assisted coil embolization.Immediate postoperative angiography showed that 2 patients had complete occlusion,3 had almost complete occlusion.Angiographic follow-up of patients showed that VADAs did not develop.No recurrence and bleeding were observed.Conclusions The endovascular treatment of VADAs is safe and feasible.