支架辅助弹簧圈栓塞术治疗眼动脉瘤31例

目的探讨支架辅助弹簧圈栓塞术治疗眼动脉瘤的方法。方法回顾性分析31例支架辅助弹簧圈治疗的眼动脉瘤患者的临床资料。男12例，女19例；年龄18—74岁，平均52．3岁。其中13例有高血压病史，10例有糖尿病史，6例合并脑缺血表现。未破裂动脉瘤4例，Hunt—Hess分级I级3例，Ⅱ级5例，Ⅲ级15例，Ⅳ～V级4例。头痛24例，恶心、呕吐18例，有眼部症状者12例，有视力下降者8例，有视野缺损者4例，首发症状为视力下降或视野缺损者3例。结果所有支架均成功释放，其中Neuroform支架27枚，Enterprise支架4枚；完全及次全栓塞28例，部分栓塞3例。29例患者分别在术后3～32个月复查，无一例动脉瘤复发。应用格拉斯哥预后（Glasgow Outcome Scale，GOS）评分进行疗效评价，恢复优或良者（GOS5或4）26例（83．9％），一般者（GOS3）2例（6．4％），差者（GOS2）2例（6．4％），死亡（GOS1）1例（3．2％）。结论通过支架对眼动脉瘤瘤颈重塑及弹簧圈的封堵作用，使动脉瘤得到致密栓塞，效果良好。

Stent assisted coil embolization for Opthalmic artery aneurysm: a report of 31 cases

Objective To investigate the methods of stentt assisted coil embolization in the treatment of opthalmic artery aneurysm. Methods The clinical data of 31 patients with opthalmic artery aneurysm treated with stent assisted coil embolization were analyzed retrospectively. There were 12 men and 19 women. The patients ranged in age from 18 to 74 years （mean, 52.3 years）. Among them, 13 had a history of hypertension, 10 had a history of diabetes mellitus, and 6 combined with cerebral ischemia d patients were with unruptured aneurysm, Hunt ＆ Hess grade in 3 cases, Hin 5 cases , Ⅲ in 15 cases , and IV - V in 4 eases. Twenty - four patients had headache, 18 had nausea and vomit, 12 had ocular symptoms, 8 with vision descender, 4 with visual field defect. 3 patients had decreased vision or visual field defect as the initial symptom. Results All the stents were successfully released （27 Neuroform stents, and 4 Enterprise stents） ; 28 patients were embolized completely or subtotally, and 3 were embolized partially. 29 patients were reexamined 3 to 32 months after the procedures, and none of the aneurysms recurred. Glasgow outcome scale （GOS） was used for efficacy evaluation, and 26 patients （83. 9% ） had excellent or good recovery （GOS 5 or 4）, 2 （6. 4% ） with fair （ GOS 3）, 2 （6. 4% ） with poor （GOS 2）, and 1 （3. 2% ） died （GOS 1 ）. Conclusion The aneurysms were embolized densely through ophthalmic artery aneurysm neck remodeling with stentts and coil, and the effect was good.