颅内椎动脉夹层动脉瘤的介入治疗

目的 总结颅内椎动脉夹层动脉瘤的诊断和介入治疗经验。方法 分析23例颅内椎动脉夹层动脉瘤的症状和影像检查结果,并就其介入治疗策略作了回顾。结果 临床表现为自发性蛛网膜下腔出血和椎基底动脉缺血,DSA显示为血管的狭窄和扩张。采取夹层段支架植入加电解可脱卸弹簧圈(GDC)栓塞和夹层动脉GDC栓塞可有效缓解症状,防止再出血。结论 对颅内椎动脉夹层动脉瘤应根据具体情况,采取积极的手术治疗。

Interventional treatment for intracranial vertebral arterial dissection

Objective To summarize experiences in diagnosis and interventional management for intracranial vertebral arterial dissection. Methods Clinical symptoms and imaging results were analysed in 23 cases of intracranial vertebral dissection, and corresponding interventional managements were reviewed. Results Clinical symptoms consisted of spontaneous SAH and vertebrobasilar insufficiency. DSA usually showed "pearl and string" sign. Interventional management included stent assisted coiling of the dissection, embolization of the affected artery with GDC and to learn the details of the stenotic ICA and draw up and appropriate operation plan.Conclusions Direct energetic intervention should be undertaken promptly for intracranial dissection.