胼周动脉动脉瘤42例治疗分析

Microsurgical and endovascular treatment for patients with pericallosal artery aneurysm

目的探讨胼周动脉动脉瘤(PAA)治疗方法及临床疗效。方法回顾性分析2012年6月至2020年3月收治的42例PAA的临床资料。25例采用夹闭术治疗,17例行血管内栓塞治疗。结果所有动脉瘤均成功完成夹闭或栓塞,夹闭术后并发症发生率为(48.0%,12/25),栓塞术后并发症发生率(17.6%,3/17)。42例术后临床随访3~12个月,中位数6个月;夹闭术治疗25例末次随访改良Rankin量表(mRS)评分0~2分17例,3~6分8例;预后良好率为68.0%(17/25);栓塞治疗的17例末次随访mRS评分0~2分14例,3~6分3例;预后良好率为82.4%(14/17)。42例术后影像随访4~21个月,中位数9个月;夹闭术后复发率为12.0%(3/25),栓塞术后复发率为5.9%(1/17)。结论夹闭术与血管内栓塞是治疗破裂PAA的有效方法,临床上需结合病人具体情况选择个体化的治疗方式以提高治疗效果。

Objective To explore the outcomes of microsurgical and endovascular treatment for the patients with pericallosal artery aneurysm(PAA).Methods A retrospective analysis was performed on the clinical data of 42 patients with ruptured PAA who were admitted to the Central Hospital of Wuhan from June 2012 to March 2020.Of 42 patients,25 received microsurgical clipping(clipping group)and 17 endovascular embolization(embolization group).Results All the procedures were successfully completed in these 42 patients with PAA.The postoperative complication rates were 48.0%(12/25)and 18.6%(3/17)in clipping and embolization groups,respectively.The clinical follow-up(range,3~12 months;median,6 months)outcomes showed good prognosis rates(mRS≤2)of 68.0%(17/25)and 82.4%(14/17)in clipping and embolization groups,respectively.The radiologic follow-up(range,4~21 months;median,9 months)outcomes showed reccurrence rates of 12.0%(3/25)and 5.9%(1/17)in clipping and embolization groups,respectively.Conclusions Both surgical clipping and endovascular embolization are effective treatment methods for the patients with PAA.Clinically,it is necessary to choose individualized treatment method based on the specific conditions of the patients in order to improve the treatment efficacy.