微创血管栓塞术在治疗大脑后动脉动脉瘤中的应用及疗效分析

Efficacy Analysis of Minimally Invasive Embolization for the Treatment of Posterior Cerebral Artery Aneurysm

目的探讨微创血管栓塞术在治疗大脑后动脉动脉瘤中的应用及疗效。方法选取2008年1月-2010年1月我院微创血管栓塞术治疗的12例大脑后动脉动脉瘤患者进行研究,回顾性分析患者的临床症状、影像学特征、治疗方法及复发情况。结果 12例患者总共12个动脉瘤,2例为P1段动脉瘤,3例为P1、P2段交界处动脉瘤,4例为P2段动脉瘤,3例为P3段动脉瘤;其中9例为夹层或者梭形动脉瘤,3例为囊状动脉瘤。1例行球囊闭塞载瘤动脉,9例行弹簧圈栓塞动脉瘤和载瘤动脉,2例行弹簧圈栓塞动脉瘤。术后进行DSA检查,结果显示动脉瘤完全消失,10例阻断载瘤动脉患者无缺血症状,未出现神经功能缺损以及其他介入相关的并发症。术后3-6个月DSA复查,未复发动脉瘤。临床随访1-5年,患者均恢复正常生活。夹层或者梭形动脉瘤患者与囊状动脉瘤患者在治疗后的住院时间、术后至临床症状缓解时间以及复发率均无统计学差异（P〉0.05）;不同治疗方式的住院时间、术后至临床症状缓解时间以及复发率均无统计学差异（P〉0.05）。结论微创血管栓塞术治疗大脑后动脉动脉瘤的效果良好,安全性高,值得临床推广。

Objective To evaluate the application and analyze the efficacy of minimally invasive embolization for the treatment of posterior cerebral artery aneurysm. Methods 12 patients with posterior cerebral artery aneurysm from January 2008 to January 2010 in our hospital were researched. Patients ＇ clinical symptoms,imaging features,treatment and relapse were retrospectively analyzed. Results There were 12 patients with 12 aneurysms,2 cases of P1 segment aneurysm,3 cases of P1 and P2 segment junction aneurysm,4 cases of P2 segment aneurysmal,and 3 cases of P3 segment aneurysm. There were 9 cases of dissection or fusiform aneurysms,and 3 cases of cystic artery aneurysm. 1 patient was treated by balloon occlusion of the aneurysm. 9 patients was treated by coil embolization of aneurysm and parent artery. And 2 patients was treated by coil embolization aneurysm. Postoperative DSA examination showed the aneurysms disappear completely. 10 patients with blocking the parent artery had no ischemic symptoms,nor other neurologic deficits of related complications. 3 - 6 months after operation,no recurrence of the aneurysm was found in the DSA review. All the cases were followed up for 1 -5 years,and were back to normal life. Hospital stay,time of clinical remission and relapse rate of patients had no significant difference between the patients with dissection or fusiform aneurysms and that with cystic artery aneurysm（ P〉 0. 05）. Conclusion The efficacy of minimally invasive embolization for the treatment of posterior cerebral artery aneurysm is safety. It is worthy of promotion in clinic.