血管内介入治疗椎动脉颅内段夹层动脉瘤

目的 探讨血管内介入治疗椎动脉颅内段夹层动脉瘤（IVADA）的疗效。方法 回顾性分析2015年1月至2018年12月采用血管内介入技术治疗的24例IVADA的临床资料。结果 23例为单侧椎动脉夹层动脉瘤，1例为双侧椎动脉夹层动脉瘤。25枚夹层动脉瘤中，支架辅助弹簧圈栓塞18枚，单纯双支架治疗2枚，闭塞夹层动脉瘤及载瘤动脉治疗5枚；术后即刻造影显示Raymond分级Ⅰ级16枚，Ⅱ级8枚，Ⅲ级1枚。术后随访6~18个月，改良Rankin量表评分0~2分23例，3分1例；DSA复查显示2例复发，考虑相对稳定，继续随访观察。结论 血管内介入治疗IVADA疗效显著，但具体栓塞方法应进行个体化选择。

Endovascular interventional therapy for patients with intracranial vertebral artery dissecting aneurysm (report of 24 cases)

Objective To investigate the clinical efficacy of endovascular treatment for the patients with intracranial vertebral artery dissecting aneurysm (IVADA). Methods The clinical data of 24 patients with IVADA who received endovascular treatment fron January 2015 to December 2018 were analyzed retrospectively. Results Of 24 patients, 1 patient suffered from bilateral dissecting aneurysms and the other 23 were unilateral. Of 25 dissecting aneurysms, 18 dissecting aneurysms were treated with stent-assisted coiling, 2 with simple stenting, and 5 with occlusion of the proximal vertebral arteries and aneurysms. Immediate postoperative radiography showed Raymond grade Ⅰ in 16 aneurysms, grade Ⅱ in 8 and grade Ⅲ in 1. The follow-up (6~18 months) outcomes showed modified Rankin scale score of 0~2 in 23 patients and 3 in 1. DSA re-examination showed recurrence of aneusysm in 2 patients. Conclusion Endovascular treatment has significant curative effects on the patients with IVADA, but the specific embolization method should be individualized.