双支架治疗未破裂椎动脉夹层动脉瘤效果分析

Dual stenting for the treatment of unruptured vertebral artery dissecting aneurysms: analysis of clinical efficacy

目的探讨双支架治疗未破裂椎动脉夹层动脉瘤的安全性和有效性。方法回顾性分析2016年7月至2018年10月在复旦大学附属华山医院北院接受双支架(套叠式)植入治疗的32例未破裂椎动脉夹层动脉瘤患者临床资料。根据术后随访和DSA复查结果,评价双支架治疗未破裂椎动脉夹层动脉瘤的安全性和有效性。结果 32例患者双支架血流重建均获成功,支架释放成功率为100%。术中和术后均未发生瘤体破裂。术后随访1~24个月,平均12个月,结果显示19例患者(59.4%,19/32)为影像学治愈,3例(9.4%)为改善(动脉瘤体积缩小),5例(15.6%)为稳定,1例(3.1%)发生缺血事件(表现为肢体偏瘫),4例(12.5%)复发。结论双支架治疗未破裂椎动脉夹层动脉瘤安全有效,但远期疗效有待进一步验证。

Objective To investigate the safety and effectiveness of dual stenting in treating unruptured vertebral artery dissecting aneurysms. Methods The clinical data of 32 patients with unruptured vertebral artery dissecting aneurysms, who were admitted to the Affiliated Huashan Hospital North Branch of Fudan University of China to receive dual stenting(telescopic type) treatment between July 2016 and October2018, were retrospectively analyzed. Based on the follow-up results and DSA reexamination findings, the safety and effectiveness of dual stenting for unruptured vertebral artery dissecting aneurysms were evaluated.Results Successful blood flow reconstruction with dual stenting was achieved in all 32 patients. The success rate of stent release was 100%. No rupture of vertebral artery dissecting aneurysm occurred during and after operation. The patients were followed up for 1-24 months, with a mean of 12 months. Imaging cure was obtained in 19 patients(59.4%, 19/32), improvement of aneurysm(reduced volume of aneurysm) was seen in 3 patients(3/32, 9.4%), stable disease was observed in 5 patients(5/32, 15.6%), ischemic event(presenting as limb hemiplegia) occurred in one patient(3.1%, 1/32), and 4 patients developed a relapse(4/32, 12.5%).Conclusion For the treatment of unruptured vertebral artery dissecting aneurysms, dual stenting therapy is safe and effective, although its long-term effect needs to be further validated.(J Intervent Radiol, 2021, 30:761-764)