血管内治疗大脑前动脉远端动脉瘤

Effect of endovascular treatments of distal anterior cerebral artery aneurysms

目的观察血管内治疗大脑前动脉远端(DACA)动脉瘤的效果。方法回顾性分析14例接受血管内治疗的DACA动脉瘤患者(共15个动脉瘤),对10个动脉瘤行单纯弹簧圈栓塞、4个动脉瘤行支架辅助下弹簧圈栓塞,1个以Onyx胶栓塞。之后复查DSA,根据Raymond分级评价即刻疗效。术后6个月复查DSA,以改良Rankin量表(mRS)评估预后,mRS评分0~2分为结局良好。结果术后即刻12个动脉瘤Ⅰ级栓塞,3个Ⅱ级栓塞。术中、术后均未发生缺血等并发症。1例术后12 h死于动脉瘤再次破裂出血。术后6个月随访显示1例复发,10例结局良好(mRS评分0~2分),另2例mRS评分分别为3分、4分。结论个体化血管内治疗DACA动脉瘤安全、有效。

Objective To observe the effect of endovascular treatments of distal anterior cerebral artery(DACA)aneurysms.Methods Fourteen patients with 15 aneurysms of DACA who underwent endovascular treatments were retrospectively analyzed.Among 15 aneurysms,10 were treated with simple coil embolization,4 with stent-assisted with coil embolization and 1 with Onyx gel embolization.The degrees of embolization of aneurysms were evaluated according to Raymond classification through DSA immediately after embolization.The patients were reexamined 6 months after operation,and the prognosis was assessed with modified Rankin scale(mRS),those with 0-2 were regarded as good outcome.Results Among 15 DACA aneurysms,Raymond gradeⅠembolization was achieved in 12,while gradeⅡin 3.No complication such as ischemia occurred during and after operation.One patient died of re-rupture and hemorrhage of aneurysm 12 h after operation.Six months after operations,DACA aneurysm relapsed in 1 patient,10 patients had good outcome(mRS score 0-2 points),and the other 2 were found with mRS score of 3 and 4 points,respectively.Conclusion Endovascular treatments of DACA aneurysms were safe and effective.