多支架后释放技术治疗椎动脉夹层动脉瘤

Multiple-stent after coiling technique for the treatment of the dissecting aneurysm of the vertebral artery

目的 探讨多支架后释放技术治疗椎动脉夹层动脉瘤的临床效果.方法 回顾性分析2011年9月至2015年9月首都医科大学附属北京天坛医院神经介入科收治的43例（共43个动脉瘤）椎动脉夹层动脉瘤患者的临床资料.所有患者均采用多支架后释放技术进行血管内栓塞治疗.随访时间为3～18个月,平均11.6个月.结果 术后即刻造影结果显示,动脉瘤完全栓塞15例,大部分栓塞22例,疏松栓塞6例.术中未见动脉瘤破裂出血,术后患者症状改善或稳定.随访结果显示,31例动脉瘤完全栓塞或保持稳定,12例动脉瘤有不同程度的复发,其中6例再次行血管内治疗.结论 采用多支架后释放技术治疗椎动脉夹层动脉瘤效果良好,该方法有利于最大限度地栓塞动脉瘤瘤体,减少动脉瘤的复发.

Objective To investigate the clinical effect of multiple-stent after coiling technique for the treatment of the dissecting aneurysm of the vertebral artery.Methods From September 2011 to September 2015,the clinical data of 43 patients （43 aneurysms） with vertebral dissecting aneurysms admitted to the Department of Interventional Neuroradiology,Beijing Tiantan Hospital,Capital Medical University were analyzed retrospectively.All patients were embolized with the multiple-stent after coiling technique.The follow-up time ranged from 3 to 18 months （mean,11.6 months）.Results The postoperative immediate angiography results showed that the aneurysms of 15 patients were completely embolized,those of 22 were mostly embolized,and those of 6 were loosely embolized.No intraoperative aneurysm rupture was observed.The symptoms of patients were improved or stable after procedure.The aneurysms of 12 patients had different degrees of recurrence,6 of them were treated with endovascular treatment again.Conclusion The efficacy of using multiple-stent after coiling technique is good for the treatment of the dissecting aneurysm of the vertebral artery.This method is beneficial to the maximum extent of embolization of the bodies of aneurysms and reduces the reoccurrence of aneurysms.