血管内栓塞治疗基底动脉顶端动脉瘤

Endovascular Treatment of Basilar Artery Apex Aneurysms

目的报告基底动脉顶端动脉瘤的血管内栓塞治疗结果,以探讨基底动脉顶端动脉瘤血管内栓塞治疗的安全性和有效性。方法回顾性分析48例基底动脉顶端动脉瘤的血管内治疗效果。未破裂动脉瘤11例,蛛网膜下腔出血14 d以上动脉瘤37例。动脉瘤直径小于12 mm者31例,12—25 mm者14例,大于25 mm者3例。临床随访43例,平均随访时间19.5个月。脑血管造影随访33例,平均随访时间8.2个月。结果48例均行血管内栓塞治疗,其中17例应用“再塑形”技术栓塞治疗。动脉瘤100％栓塞29例(60.4％),90％以上栓塞14例(29.2％),90％以下栓塞5例(10.4％)。缺血性并发症2例。无死亡。33例造影复查:25例同栓塞当时相比无变化,8例复发,其中7例是由于弹簧圈发生回缩而复发,4例再次行栓塞治疗。8例复发动脉瘤中,7例动脉瘤直径大子12 mm,1例小于12 mm。临床随访过程中无动脉瘤再破裂。结论血管内栓塞治疗是基底动脉顶端动脉瘤安全有效的治疗方法;动脉瘤的大小和动脉瘤颈是影响治疗效果的重要因素。

Objective To explore the safety and efficacy of endovascular treatment of basilar artery apex aneurysms. Methods The data of 48 patients with basilar artery apex aneurysms, who received endovascular treatment, were analysed retrospectively. Of 48 basilar artery apex aneurysms, 11 unruptured and 37 ruptured. Thirty-one aneurysms had diameters of <12mm, 14 had 12-15 mm and 3 had > mm. Seventeen aneurysms were endovascularly treated with remodelling technique. Results One hundred percent occlusion of aneurysms was achieved in 29 patients, more than 90% in 14, less than 90% in 5. Ischemic events were encountered after the embalization in 2 cases and no patients died. Angiographic follow-up (mean 8.2 months) in 33 patients showed that 8 aneurysms, of which, 7 were more than 12 mm in diameter and 1 less than 12 mm, recurred. Forty-three patients were clinically followed up for 19.5 months and no aneurysm ruptured during the clinical follow-up period. Conclusion Endovascular embolization was the effective and safe method of treating the basilar artery apex aneurysms; The size and the neck of the aneurysms were the important factors influencing the endovascularly treatment effect on the aneurysm.