颈内动脉颅外段严重迂曲病人颅内动脉瘤的血管内栓塞治疗分析

Clinical analysis of interventional therapy for intracranial aneurysms in patients with severe tortuosity of extracranial internal carotid artery

目的探讨颈内动脉颅外段严重迂曲病人颅内动脉瘤进行血管内栓塞治疗的可行性及安全性。方法回顾性分析2016年6月到2017年8月收治的11例颅内动脉瘤伴颈内动脉颅外段血管严重迂曲病人临床资料,均采用血管内栓塞治疗。结果11例术后即刻DSA示动脉瘤消失,载瘤动脉通畅,无血管夹层、支架内血栓形成、术中动脉瘤破裂或脑梗死等并发症。11例出院后随访3~12个月,均无神经功能缺失表现。5例术后6个月复查DSA未见动脉瘤复发,载瘤动脉通畅。结论伴颈内动脉颅外段严重迂曲的颅内动脉瘤,根据病人具体情况,在相关血管内技术的辅助下,进行栓塞治疗仍是一种相对可行、安全和有效的治疗手段。

Objective To investigate the feasibility and safety of endovascular embolization of intracranial aneurysms in patients with severe tortuosity of extracranial internal carotid arteries.Methods The clinical data of11intracranial aneurysm patients with severe tortuosity of extracranial internal carotid arteries diagnosed by DSA who underwent endovascular embolization in our hospital from June,2016to August,2017were analyzed retrospectively.Of these11patients,whose age ranged from39to78years old(mean,51years old),5were male and6female.All the patients were followed up from3to9months.Results All the patients were successfully treated with simple coils embolization technique or stent-assisted coiling technique.The intraoperative cerebrovascular spasm occurred in2patients.The other complications including intracranial hemorrhage,carotid artery dissection and transient ischemic attack did not occur in all the patients.No patients died or suffered from neurologic events in these11patients during the following-up.Conclusions The catheter insertion during the endovascular interventional treatment procedure is difficult in the intracraial aneurysms patients with severe tortuosity of the extracranial internal carotid arteries.However,the endovascular treatment is still a relatively feasible,safe and effective method to treat intracranial aneurysms in the patients with severe tortuosity of the extracranial internal carotid arteries who do not consent to craniotomy or had the contraindication of the craniotomy for the intracranial aneurysms.