弹簧圈栓塞动脉瘤及载瘤动脉治疗出血性椎动脉夹层动脉瘤

目的探讨采用弹簧圈栓塞动脉瘤及载瘤动脉治疗出血性椎动脉夹层动脉瘤的疗效及并发症。方法收集经颅脑CT及全脑DSA确诊的椎动脉夹层动脉瘤破裂出血患者17例,采用弹簧圈栓塞动脉瘤及载瘤动脉,观察疗效及并发症。结果 17例动脉瘤及载瘤动脉均完全闭塞,无死亡病例。术后当天1例发生Wallenberg综合征,恢复良好;1例术后3个月出现脑积水,行侧脑室-腹腔分流术后遗留轻度残疾;随访2~36个月,无再出血病例。术后6个月12例接受DSA复查,动脉瘤完全不显影,载瘤动脉未发生再通。结论应用弹簧圈栓塞夹层动脉瘤及载瘤动脉治疗出血性椎动脉夹层动脉瘤疗效确切,具有一定应用价值。

Embolization of aneurysms and parent arteries with coils in treatment of ruptured vertebral artery dissecting aneurysms

Objective To assess the efficiency and complications of embolization of aneurysms and parent arteries with coils in treatment of ruptured vertebral artery (VA) dissecting aneurysm. Methods Totally 17 patients with ruptured VA dissecting aneurysm confirmed by CT and DSA of brain were enrolled, and the aneurysms and parent arteries were embolized with coils at the same time. The efficiency and complications of therapeutic procedures were assessed. Results The aneurysms and parent arteries were completely closed up in all the 17 patients and no death occurred. On the day of operation, Wallenberg syndrome occurred in 1 case who got good recovery. Hydrocephaly occurred in 1 case 3 months after operation with slight disability after establishment of ventriculo-peritoneal shunt. No rebleeding occurred during the follow-up period of 2 to 36 months. The aneurysms did not develop, and the parent arteries were not recanalized in all 12 patients who underwent DSA reexamination. Conclusion Embolization of aneurysms parent arteries with coils for treatment of ruptured VA dissecting aneurysm is effective.