后循环动脉瘤的血管内治疗

目的 探讨血管内治疗后循环动脉瘤的安全性和可行性.方法 本组收治后循环动脉瘤47例,其中基底动脉顶端动脉瘤25例,小脑上动脉瘤4例,小脑后下动脉瘤5例、小脑前下动脉瘤2例,椎动脉解离性动脉瘤9例,多发动脉瘤2例,其中23例采用微弹簧圈栓塞治疗,7例采用球囊辅助微弹簧圈栓塞,16例采用Neuroform支架结合微弹簧圈治疗,1例椎动脉小宽颈动脉瘤采用单纯Neuroform支架瘤颈成形术.结果 100%栓塞37例,95%栓塞9例.死亡1例.短期随访无再次蛛网膜下腔出血,5例复查脑血管造影,显示载瘤动脉通畅,动脉瘤无复发,1例单纯支架成形患者复查造影动脉瘤消失.结论 血管内治疗是治疗后循环动脉瘤的安全有效的治疗手段,对于宽颈动脉瘤应采用球囊辅助或支架成形栓塞以提高栓塞率.

Endovascular therapy of posterior circulation aneurysms

Objective To investigate the safety and feasibility of endovascular therapy in posterior circulation aneurysms. Method There were 47 patients with posterior circulation aneurysms in this group, 25 aneurysms located in the apex of basilar artery,4 aneurysms in superior cerebellar artery,5 aneurysms in posterior inferior cerebellar artery,2 aneurysms in anterior inferior cerebellar artery,9 dissect aneurysms in vertebral artery,other 2 patients suffered from multiple aneurysms. 23 patients were treated with coiling, 16 patients with balloon assisted coiling, 7 patients with Neuroform stent assisted coiling, 1 patient was with Neuroform stent. Results 37 patients received complete occlusion,9 patients received 95% occlusion. 1 patient combined with Moyamoya disease died of widespread brain swelling and cerebral hernia after the procedure. There was no SAH within follow-up period. DSA was performed in 5 patients, there was no recurrence. The patient solo-treated with stent was followed up with DSA one month later,and the aneurysm disappeared. Conclusions Endovascular therapy is a valuable and safe method for treatment of posterior circulation aneurysms, balloon remodeling and stent assistant embolization should be performed in wide-necked aneurysms.