Objective The purpose of the current study was to evaluate the method and result of endovascular treatment for a giant unruptured dissection of the basilar artery (BA) . Methods A 14-year-old boy underwent computed to...Objective The purpose of the current study was to evaluate the method and result of endovascular treatment for a giant unruptured dissection of the basilar artery (BA) . Methods A 14-year-old boy underwent computed tomography (CT) scan following a minor head trauma was incidentally found a lesion located展开更多
患者男性,59岁,主因突发头晕伴行走不稳3 d,于2015年9月20日入院。患者3 d前跑步时无明显诱因突发头晕伴行走不稳,休息后症状加重并出现右眼视物模糊和右侧听力下降,当地医院行头部CT和MRI检查提示基底动脉延长扩张症伴动脉瘤,右侧小脑...患者男性,59岁,主因突发头晕伴行走不稳3 d,于2015年9月20日入院。患者3 d前跑步时无明显诱因突发头晕伴行走不稳,休息后症状加重并出现右眼视物模糊和右侧听力下降,当地医院行头部CT和MRI检查提示基底动脉延长扩张症伴动脉瘤,右侧小脑新发梗死（图1a,1b）。为求进一步手术治疗,遂至我院就诊。患者既往有高血压（高血压3级,极高危）20余年,血压最高达180/110 mm Hg（1 mm Hg=0.133 k Pa）,规律服用硝苯地平20 mg/d,展开更多
本研究经济宁医学院附属医院伦理委员会批准,免除受试者知情同意,批准文号:20211216。患者女,27岁,因“左侧肢体无力5 h”入院。患者入院前5 h无明显诱因出现左侧肢体无力,无法行走,左上肢抬起不能,伴头晕,无意识不清,无抽搐,无发热,在...本研究经济宁医学院附属医院伦理委员会批准,免除受试者知情同意,批准文号:20211216。患者女,27岁,因“左侧肢体无力5 h”入院。患者入院前5 h无明显诱因出现左侧肢体无力,无法行走,左上肢抬起不能,伴头晕,无意识不清,无抽搐,无发热,在当地医院急查颅脑CT未见明显异常,转我院进一步诊治。家属诉患者近来经常熬夜。既往体健,否认高血压、糖尿病史,否认外伤史,否认吸烟、饮酒史,否认药物滥用史,否认家族类似病史。入院查体:血压126/78 mm Hg(1 mm Hg=0.133 kPa),神志清,言语欠流利,双眼向左侧凝视,左上肢肌力2级、左下肢肌力4级。展开更多
Background： The endovascular strategy of the huge dissecting aneurysms involving the basilar artery （BA） is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the...Background： The endovascular strategy of the huge dissecting aneurysms involving the basilar artery （BA） is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping （IT） technique. Methods： We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. Results： All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months alter the endovascular treatment （median 8 months）, 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. Conclusions： The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.展开更多
文摘Objective The purpose of the current study was to evaluate the method and result of endovascular treatment for a giant unruptured dissection of the basilar artery (BA) . Methods A 14-year-old boy underwent computed tomography (CT) scan following a minor head trauma was incidentally found a lesion located
文摘患者男性,59岁,主因突发头晕伴行走不稳3 d,于2015年9月20日入院。患者3 d前跑步时无明显诱因突发头晕伴行走不稳,休息后症状加重并出现右眼视物模糊和右侧听力下降,当地医院行头部CT和MRI检查提示基底动脉延长扩张症伴动脉瘤,右侧小脑新发梗死（图1a,1b）。为求进一步手术治疗,遂至我院就诊。患者既往有高血压（高血压3级,极高危）20余年,血压最高达180/110 mm Hg（1 mm Hg=0.133 k Pa）,规律服用硝苯地平20 mg/d,
文摘本研究经济宁医学院附属医院伦理委员会批准,免除受试者知情同意,批准文号:20211216。患者女,27岁,因“左侧肢体无力5 h”入院。患者入院前5 h无明显诱因出现左侧肢体无力,无法行走,左上肢抬起不能,伴头晕,无意识不清,无抽搐,无发热,在当地医院急查颅脑CT未见明显异常,转我院进一步诊治。家属诉患者近来经常熬夜。既往体健,否认高血压、糖尿病史,否认外伤史,否认吸烟、饮酒史,否认药物滥用史,否认家族类似病史。入院查体:血压126/78 mm Hg(1 mm Hg=0.133 kPa),神志清,言语欠流利,双眼向左侧凝视,左上肢肌力2级、左下肢肌力4级。
基金Source of Support： This work was supported by grants from the National Science Foundation of China （No. 81220108007, 81171079, 81371315 and 81471167） and Special Research Project for Capital Health Development （No. 2014-1-1071）. Conflict of Interest： None declared.
文摘Background： The endovascular strategy of the huge dissecting aneurysms involving the basilar artery （BA） is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping （IT） technique. Methods： We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. Results： All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months alter the endovascular treatment （median 8 months）, 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. Conclusions： The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.
