巨大海绵窦段动脉瘤的血管内治疗

目的 通过评估影像资料和临床预后来探讨血管内治疗巨大海绵窦段动脉瘤的安全性和有效性。方法 回顾性分析2006年1月～ 2012年2月,连续接诊的行血管内治疗的巨大海绵窦段动脉瘤患者的临床和影像资料及随访结果.分析评价手术的可行性、手术并发症及影像和临床预后。结果 共有27例患者27个巨大海绵窦段动脉瘤行血管内治疗.其中17例行载瘤动脉闭塞,8例支架辅助弹簧圈栓塞,2例单纯弹簧圈栓塞,术后即刻造影显示完全栓塞率、近全栓塞率和部分栓塞率分别为81.5％、11.1％和7.4％.无死亡病例,手术相关并发症发生率为7.4％.在为期32.9±17.3个月（4～71个月）的随访中,25例（92.6％）的预后良好（mRS评分0～1分）,统计学分析显示高龄（60岁以上）与不良预后相关（P=0.006）.结论 血管内治疗巨大海绵窦段动脉瘤安全有效,有症状的巨大海绵窦段动脉瘤应及时治疗,对于高龄患者治疗应慎重。

Endovascular Treatment for Giant Cavernous Carotid Artery Aneurysms

Objective To evaluate the outcome of endovascular treatment for giant cavernous carotid artery aneurysms.Methods We retrospectively reviewed a series of 27 consecutive giant cavernous carotid artery aneurysms （CCAAs） treated with endovascular.The technical feasibility of the procedure,complications,angiographic results,clinical outcome were assessed.Results Seventeen aneurysms were treated by parent artery occlusion （PAO）,8 aneusyms were treated with stent-assisted coil embolization,and 2 aneurysms were embolized with coils.The initial post-procedure angiogram revealed complete occlusion,neck remnant,and incomplete occlusion in 81.5％,11.1％ and 7.4％,respectively.Procedure-related mortality and morbidity were 0 and 7.4 ％,respectively.At 32.9 ± 17.3 months （4-71months） follow-up,good clinical outcome （mRS 0-1） was observed in 25 （92.6％） patients.Statistical analysis showed that risk factors for poor clinical outcome included age of 60 years and older（P =0.006）.Conclusion The outcome of endovascular treatment of giant CCAAs is promising.Risk factors for poor clinical outcome of giant CCAAs included conservative treatment and older than 60.