颅内段椎动脉夹层动脉瘤的血管内治疗

Endovascular treatment of intracranial vertebral artery dissecting aneurysms

目的探讨椎动脉夹层动脉瘤的血管内治疗方法。方法回顾性分析本手术组2006年1月～2014年5月间接诊的41例椎动脉夹层动脉瘤病例,其中35例分别采用了3种不同的血管内治疗技术,另6例进行了随诊观察。结果 41例均获得随访,时间为3～18个月。其中1例行支架辅助弹簧圈治疗的病人复发,2例未治疗的病人动脉瘤增大。结论治疗组和观察组做统计学分析（P〈0.01）,血管内治疗椎动脉夹层动脉瘤是一种较为安全、可靠的方法,根据动脉瘤的形态、与小脑后下动脉的关系及对侧椎动脉的发育情况等因素来选择不同的血管内治疗。

Objective To investigate the methods of endovascular treatment for vertebral artery dissecting aneurysms （VADAs）. Methods The clinical data of 41 patients with VADAs treated by our operation group from January 2006 to May 2014 were analyzed retrospectively. Of the 41 patients, 35 underwent three different endovascular treatments, and the other 6 were followed up for observa- tion. Results The 41 patients were followed up from 3 - 18 months. Among them, 1 patient treated by stent-assisted coil trapping had a relapse, and 2 untreated patients suffered from enlarged aneurysms. Conclusions The data of the treatment group and the observa- tion group were statistically analyzed （ P 〈 0.01 ）. Endovascular treatment of VADAs is safe and reliable. Different endovascular treat- ments can be chosen according to the appearance of the aneurysm, the relationship with the posterior inferior cerebellar artery, the de- velopment of the contralateral vertebral artery and so on.