颈内动脉巨大动脉瘤的血管内治疗

目的探讨血管内栓塞方法治疗颈内动脉巨大动脉瘤的效果和安全性。方法回顾性分析3例应用弹簧圈进行瘤腔内栓塞和27例应用载瘤动脉闭塞方法治疗的颈内动脉巨大动脉瘤的结果和随访资料。结果2例瘤腔内栓塞动脉瘤的患者症状完全消失;1例患者出现缺血性并发症,半年后随访动脉瘤再通。球囊闭塞载瘤动脉的患者1例出现迟发缺血性症状;1例吻合支开放,3个月后患者出血死亡;其余患者症状均有不同程度改善。结论颅内巨大动脉瘤是否进行瘤囊内弹簧圈栓塞需要综合考虑各种条件,采用个体化的治疗方案。球囊闭塞载瘤动脉是比较安全有效的方法。

Endovascular treatment of giant intracranial aneurysms in the internal carotid artery

Objective To investigate the efficacy and safety of endovascular treatment for giant intracranial aneurysms in the internal carotid artery.Methods A retrospective analysis was carried out on 3 cases treated with endosaccular embolization and 27 cases treated with parent artery occlusion with balloon in patients with giant aneurysms of internal carotid artery.Results The symptoms of two patients treated with endosaccular embolization disappeared totally, while one patient presented transient ischemia and the aneurysm was recanalized half a year later. Among the 27 patients treated with parent artery occlusion, only one suffered from delayed ischemic deficits and one died 3 months later for potential anastamosis of internal carotid artery and external carotid artery. Symptoms of other patients ameliorated in different degrees.Conclusion All factors should be considered and an individualized treatment strategy should be made before the endosaccular embolization of giant intracranial aneurysms is taken. Occluding parent artery to manage giant aneurysms of internal carotid artery is an effective and safe method.