血管内栓塞治疗伴动眼神经麻痹的颈内动脉后交通段动脉瘤的疗效分析

Endovascular treatment of posterior communicating aneurysms complicated with oculomotor nerve palsy(report of 25 cases)

目的探讨血管内栓塞治疗伴动眼神经麻痹的颈内动脉后交通段动脉瘤的疗效。方法回顾性分析2016年1月至2017年1月血管内栓塞治疗的25例伴动眼神经麻痹的颈内动脉后交通段动脉瘤的临床资料。结果 24例(26枚动脉瘤)行LVIS辅助弹簧圈栓塞治疗,完全栓塞19枚,近全栓塞7枚;其中2例(4枚)为双侧对称大型颈内动脉后交通段动脉瘤均完全栓塞。另外1例(1枚后交通动脉瘤)瘤腔较小(1.0 mm×1.5 mm×1.9 mm),弹簧圈反复无法置入瘤腔内,故应用单纯LVIS支架贴敷术。术后随访6个月～1年。19例动眼神经麻痹完全恢复,3例部分恢复,3例无变化。结论血管内栓塞治疗伴动眼神经麻痹的颈内动脉后交通段动脉瘤疗效显著,部分病人动眼神经功能恢复不佳。

Objective To explore the treatment of posterior communicating artery(PCOA)aneurysms complicated with oculmotor nerve palsy(OMNP).Method The clinical data25patients with27PCOA aneurysms compliated with OMNP,who underwent endovascular treatment from January,2016to January,2017,were analyzed retrospectively.Results Of26aneurysms,24were totally occluded and2subtotally with LVIS stent-assisted coiling embolization.Another aneurysms was embolized only with LVIS stent.The following-up from6months to1year showed that of25patients,15were completly recovered from OMNP,7partly and3not.Conclusions Most OMNP caused by PCOA aneurysms may be cured by the endovascular embolization of PCOA aneurysms.And some patients with OMNP caused by the PCOA aneurysms can not recover completely after the embolization of PCOA aneurysms probably due to the irreversible damage to the oculomotor nerves caused by the aneurysmal long-term pressure.