| 摘要: |
| 目的 探讨多支架重建性治疗未破裂动脉瘤的可行性和安全性。方法 回顾性分析2009年6月至2014年4月我科收治的38例采用弹簧圈+双支架重叠/三支架重叠进行血流重建治疗的未破裂椎动脉夹层动脉瘤患者的临床资料,分析临床疗效及随访资料,评估多支架重建性治疗未破裂动脉瘤的可行性和安全性。结果 所有患者均采用多支架血流重建性治疗,支架释放成功率为100%。术后即刻栓塞结果:8例完全栓塞,7例次全栓塞,23例部分栓塞;术中无血栓形成。影像学随访结果:38例患者中1例(2.6%,1/38)术后发生缺血事件;8例完全栓塞和7例次全栓塞复查结果为影像学治愈;23例部分栓塞患者中,9例影像学治愈,6例改善,8例稳定。临床随访结果:术后随访19个月(4~126个月),所有患者术后均获得良好预后,mRS评分为0或1。结论 应用多支架辅助弹簧圈栓塞治疗未破裂椎动脉夹层动脉瘤安全可行,但仍有待大样本研究进一步证实。 |
| 关键词: 夹层动脉瘤 椎动脉 血管内介入治疗 支架 |
| DOI：10.3724/SP.J.1008.2015.00177 |
| 投稿时间：2014-11-20修订日期：2015-01-05 |
| 基金项目:国家自然科学基金(81301004). |
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| Reconstructive treatment with multiple stents and coiling for unruptured vertebral artery dissecting aneurysms |
| LI Li,ZHAO Kai-jun,FANG Yi-bin,LI Qiang,ZHANG Qi,XU Yi,HONG Bo,HUANG Qing-hai,LIU Jian-min* |
(Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To evaluate the feasibility and safety of reconstructive treatment with multiple stents and coiling for un-ruptured vertebral artery dissection aneurysms (UVADAs). Methods A retrospective review was conducted for all the patients who underwent reconstructive treatment with multiple stents (2 or 3) and coiling for UVADAs in our department between June 2009 and April 2014; the clinical outcomes and follow-up data were analyzed to assess the feasibility and safety of reconstructive treatment with multiple stents and coiling for UVADAs. Results All patients were treated with multi-stents and coiling and the successful release rate of stents was 100%. Immediate occlusion outcome after operation was as follows: total obliteration was achieved in 8 cases, subtotal obliteration in 7 cases, partial obliteration in 23 cases; there were no intra-operative thrombosis. Angiographic followed-up outcome was as follows: one case (2.6%, 1/38) had ischemic event; 8 cases with total obliteration and 7 with subtotal obliteration had imaging cure; among the 23 cases with partial obliteration, 7 had imaging cure, 7 had improved imaging, and 8 had stable imaging. All the patients had satisfactory outcomes during a follow-up of 19-month (4-126 months), with mRS score being 0-1. Conclusion Our preliminary experience suggests that reconstructive treatment with multiple stents and coiling is feasible and safe for UVADAs, but the conclusion needs to be further verified by large sample studies. |
| Key words: dissecting aneurysm vertebral artery endovascular treatment stents |
