血管内支架及电解可脱卸弹簧圈治疗颅内椎动脉梭形动脉瘤

目的 :报告联合使用支架及电解可脱卸弹簧圈 (GDC)治疗颅内梭形动脉瘤的临床体会。方法 :1例蛛网膜下腔出血的 5 0岁男性患者 ,数字减影血管造影 (DSA)、计算机断层扫描血管造影 (CTA)、磁共振血管造影 (MRA)检查显示右椎动脉颅内段梭形动脉瘤 ,大小 8.9mm× 6 .8mm,瘤颈宽 8.9m m,瘤颈 /体比 >1。于动脉瘤破裂出血后 35 d行血管内介入治疗 ,首先将冠状动脉支架跨动脉瘤颈放置 ,通过支架的网孔将微导管输送入动脉瘤腔 ,填入 GDC。 结果 :支架定位准确 ,GDC致密填塞 ,载瘤动脉及小脑后下、前下动脉均通畅 ,患者术后 7d痊愈出院。 结论 :联合使用支架及微弹簧圈可能成为治疗梭形及宽颈动脉瘤的有效方法。

Treatment of an intracranial fusiform vertebral artery aneurysm with endovas-cular stent and Guglielmi detachable coils

Objective:To report on a case of intracranial vetebral arteryfusiform aneurysm treated by combined endovascular stenting and Guglielmi detachable coils.Methods:A middle-aged male presented with subarachnoid hemorrhage.DSA,CTA,and MRA revealed an intracranial vertebral artery fusiform aneurysm.The aneurysm measured 8.9 mm×6.8mm,with a large neck (8.9 mm) and neck/dome ratio＞l.Endovascular therapy was given 35 days after hemorrhage.A coronary stent was implanted across the neck of the aneurysm.A microcatheter was introduced into the aneurysm sac through stent mesh,GDCs were used to embolize the aneurysm.Results:The stent was stable,and the aneurysm was obliterated by dense packing with GDCs.The patient was discharged 7 days after the treatment,with patency of the parent artery,PICA,and AICA.Conclusion:Endovascular therapy by stent implantation and microcoil placement may become a viable option for the treatment of fusiform or wide necked aneurysms.