烟雾病合并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效果。方法回顾性分析2012年9月至2013年9月采用血管内栓塞治疗的7例烟雾病合并颅内血流相关性动脉瘤患者的临床资料,其中采用单纯弹簧圈栓塞3例,支架辅助弹簧圈栓塞3例,ONYX胶栓塞1例。结果 7例患者中3例表现为蛛网膜下腔出血,3例表现为脑室出血,1例表现为顶枕部脑内出血;3例动脉瘤位于基底动脉顶端,1例位于脉络膜前动脉,1例位于大脑后动脉顶枕支,2例位于胼周动脉。7例均成功行血管内栓塞治疗,6例随访均获良好疗效。结论烟雾病合并血流相关性动脉瘤可导致不同类型的颅内出血,血管内栓塞治疗烟雾病合并颅内动脉瘤安全、有效。

Objective To explore the clinical characteristics of intracranial aneurysms associated with Moyamoya disease （MMD） and the curative effect of the endovascular embolization on them. Methods The clinical data of 7 patients with intracranial aneurysms associated with MMD, who received the endovascular embolization of the intracranial aneurysms in our department from September, 2012 to September, 2013, were analyzed retrospectively. Of 7 patients, 5 underwent coils embolization, 1 stent-assisted coils embolization and 1 ONYX glue embolization. Results Of the 7 patients, 3 had SAH, 3 ventricular hemorrhage and 1 parietal occipital hemorrhage. Of 7 intracranial aneurysms, 3 were on the top of base arteries, 1 was in choroid anterior artery, 1 was in the parietal-occipital branch of posterior cerebral artery, 2 were in pericallosal arteries. Seven aneurysms were successfully embolized, and 6 patients had excellent clinical outcomes. Conclusions The intracranial aneurysms associated with MMD may result in the different types intracranial hemorrhage. The endovascular embolization of the intracranial aneurysms associated with MMD is safe and its curative effect on the intracranial aneurysms associated with MMD is good.