血管内介入治疗大脑后动脉夹层动脉瘤

Endovascular treatments of posterior cerebral artery dissecting aneurysms

目的观察血管内介入治疗大脑后动脉夹层动脉瘤的效果。方法回顾性分析12例接受血管内介入治疗的大脑后动脉夹层动脉瘤患者,评价治疗效果。结果12例大脑后动脉夹层动脉瘤中,P1段2例,P1-P2段2例,P2段6例,P3段2例,均成功实施栓塞治疗;对其中2例单纯以弹簧圈栓塞动脉瘤,8例以弹簧圈闭塞载瘤动脉,2例植入支架。术后即刻行复查造影显示Raymond分级1级10例,2级2例。术后4例诉头痛,经对症治疗后2周内好转;未见动脉瘤破裂出血及脑梗死。随访期间影像学检查均未见动脉瘤复发,无新发神经功能障碍及颅内再次出血;末次随访时改良Rankin量表0分10例,1分1例,2分1例。结论血管内介入治疗大脑后动脉夹层动脉瘤效果较好,且安全性较高。

Objective To observe the effects of endovascular treatments of posterior cerebral artery dissecting aneurysms.Methods Data of 12 patients with posterior cerebral artery dissecting aneurysm who underwent endovascular treatments were retrospectively analyzed,and the therapeutic effects were observed.Results Posterior cerebral artery dissecting aneurysms were detected in all 12 patients,located in P1 segment in 2 cases,in P1-P2 segment in 2 cases,in P2 segment in 6 cases and in P3 segment in 2 cases.Transcatheter endovascular embolization were successfully completed in all patients,using coils to embolize the aneurysms in 2 cases,using coils to embolize both aneurysms and parent segment in 8 cases,while coiling assisted with stent implantation in 2 cases.According to immediate DSA after occlusions,10 cases were in Raymond scale class 1 and 2 cases were in class 2.Four patients complained headache after operation,but improved within 2 weeks after symptomatic treatment.No aneurysm rupture,cerebral infarction,newly-developed neurological dysfunction nor intracranial rebleeding was found during follow-up.At the last follow-up,the modified Rankin scale score was 0 point in 10 cases,1 point in 1 case and 2 points in 1 case.Conclusion Endovascular treatments of posterior cerebral artery dissection aneurysm were effective and safe.