颈内动脉床突旁动脉瘤的血管内治疗

Endovascular embolization of paraclinoid aneurysms of internal carotid arteries(report of 104 cases)

目的探讨血管内治疗床颈内动脉突旁动脉瘤的效果和安全性。方法对接受血管内治疗的104例（共112个）床突旁颈内动脉动脉瘤患者的临床资料进行回顾性分析。结果栓塞后即时造影显示，83个动脉瘤（74．1％）完全闭塞，16个（14．3％）瘤颈残留，13个（11．6％）瘤体残留。93个（83％）动脉瘤获造影随访3个月～2年，88个（94．6％）动脉瘤显示稳定或完全闭塞，5个（5．4％）复发。发生手术相关并发症2例（1．9％），无死亡病例。结论血管内弹簧圈栓塞治疗床突旁动脉瘤是一种安全有效的方法。

Objective To evaluate the safety of endovascular embolization of paraclinoid aneurysms of internal carotid arteries （ICA） and its effect. Methods The clinical data of 104 patients with 112 paraclinoid aneurysms of ICA receiving endovascular embolization from 2009 to 2013 were analyzed retrospectively. Of 112 paraclinoid aneurysms, 36 belonged in type [ a, 24 in type I b, 28 in type Ⅱ , 21 in type Ⅲ, and 3 in type Ⅳ according to A1-Radhan classification. Thirty-two aneurysms were embolized with coils and 80 with stent-assisted coiling technique. Results DSA immediately after the treatment showed that of 112 aneurysms, 83 （74.1%） were completely occluded, 13 （11.6%） incompletely and 16 （14.3%） had aneurysmal neck remnant. The postoperative complications included incompletely occlusion of the central artery of retina in 1 patient and basal ganglion hemorrhage 3 days after the embolization in 1. Of 93 aneurysms followed up from 3 months to 2 years, 88 were completely stably occluded and 5 recurred. Conclusion The endovascular embolization is a safe and effective method to treat the paraclinoid aneurysms of CIA.