大脑后动脉远端动脉瘤的血管内介入治疗

目的 探讨大脑后动脉远端动脉瘤的血管内介入治疗方法及特点.方法 10例动脉瘤,P2段6例(囊状2例、梭形2例、夹层2例)、P2-P3交界处1例(夹层)、P3段3例(夹层).对于囊状动脉瘤采用弹簧圈栓塞并保留载瘤动脉的方法;梭形动脉瘤采用支架重建瘤腔的方法;P2段及P2-P3交界夹层动脉瘤采用弹簧圈栓塞并闭塞载瘤动脉的方法;P3段夹层动脉瘤采用Glubran胶栓塞并闭塞载瘤动脉的方法.结果 随访半年至1年,预后良好.DSA复查9例,未见动脉瘤复发.结论 对于大脑后动脉远端动脉瘤,根据动脉瘤的类型及部位采用不同的血管内介入治疗方法,短期随访可以获得较好的疗效.

Endovascular treatments for distal posterior cerebral artery aneurysms

Objective The purpose of the current study was to evaluate the methods and results of endovascular treatments for distal posterior cerebral artery (PCA) aneurysms. Methods Over 5 years we studied 10 patients admitted to our hospital, of 6 had aneurysms at the P2 segment (2 were saccular, 2 were fusiform, 2 were dissecting), 1 had a dissecting aneurysm at the P2-P3 junction and 3 had dissecting aneurysms at the P3 segment. Different strategies were used, depending on the locations and shapes of the aneurysms. Specifically, coil embolization was used for saccular aneurysms to retain parent arteries, stent was used for fusiform aneurysm to reconstruct the parent arteries, coil embolization in combination with parent artery occlusion was used for dissecting aneurysms at P2 segment or P2-P3 junction, aneurysm embolization in combination with parent artery occlusion by Glubran glue were used for dissenting aneurysms at the P3 segment. Results Postoperative follow-up in 9 patients demonstrated that these treatments achieved good recovery; one patient was lost. All the aneurysms had no recurrence in the follow up of DSA.Conclusion Taken together, the results of this study suggested that to achieve a satisfying prognosis, the types and locations of the aneurysms should be considered when performing the endovascular treatment for distal PCA aneurysms.