颅内段椎动脉夹层动脉瘤的初步分型和介入治疗

Study of typing and endovascular interventional therapy for intracranial vertebral arterydissecting aneurysm

目的探讨颅内段椎动脉夹层动脉瘤的初步分型及介入治疗策略。方法按照动脉瘤与小脑后下动脉（PICA）的位置关系以及对侧椎动脉的发育情况进行初步分型，并根据分型选择合适的介入治疗方法。结果31例颅内段椎动脉夹层动脉瘤中，完全栓塞21例，部分栓塞9例，未栓塞1例。其中闭塞椎动脉10例，随访造影动脉瘤均无复发；支架辅助栓塞18例，术后随访造影明显复发2例，瘤颈部复发2例；2例直接栓塞无复发；保守治疗1例未复查造影。结论通过对颅内段椎动脉夹层动脉瘤的合理分型，可为介入治疗提供依据。

Objective To explore the type of the vertebral artery dissecting aneurysm and the optimal endovascular interventional therapy strategy. Methods The aneurysms were typed according to the location relationship between the aneurysm and posterior - inferior eerebellar artery （PICA） and the developmental state of the opposite vertebral artery （subtypes）. Different endovascnlar interventional therapy strategies were selected according to the typing. Results 10 received parent artery occlusion, and follow - up angiography showed no recurrence of aneurysm. 18 patients received the stent- assistant coiling, 2 cases recurred significantly, 2 cases recurred in neck part. 2 cases received coiling without recurrence and 1 received conservative treatment without follow - up angiography. Conclusions It is more effective and safer to select appropriate endovascular interventional therapy according to the typing of aneurysm.