颅内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疗效。方法回顾性分析经血管内治疗的20例颅内后循环动脉瘤患者的临床资料,其中动脉瘤位于基底动脉顶端10例、大脑后动脉2例、小脑后下动脉4例、椎动脉动脉4例;12例采用微弹簧圈栓塞治疗,8例采用支架辅助弹簧圈栓塞治疗。结果术后即刻造影示动脉瘤90%~94%栓塞6例,≥95%栓塞14例。本组术后死亡2例。18例患者出院后随访3~24个月,无动脉瘤再次破裂出血病例;12例患者复查CT血管造影,未见动脉瘤复发;13例患者恢复良好,3例中残,1例重残,1例植物生存。结论血管内治疗是一种微创、安全、有效的治疗后循环动脉瘤的方法。

Effectiveness of coil embolization for posterior circulation aneurysms

ObjectiveTo investigate the effectiveness of coil embolization for posterior circulation aneurysms（PCAs）.Method The clinical data of 20 patients with PCAs who underwent coil embolization from September 2009 to September 2012 were analyzed retrospectively.ResultsTwo,three,eight,five and two patients belonged to Hunt-Hess grade 0,Ⅰ,Ⅱ,Ⅲ,Ⅳbefore embolization,respectively.Of 20 PCAs,10 aneurysms located at the apex of basilar artery,2 at posterior cerebral artery,4 at posterior inferior cerebellar artery and 4 at vertebral artery.Twelve patients were embolized with coils alone and 8 with Neuroform stent-assisted coils.The DSA images obtained immediately after embolization showed that greater than or equal to 95% occlusion was achieved in 14patients,and 90%~94% in 6.Two patients died after embolization.Eighteen patients were followed up for 3~24 months after discharge.According to GOS score,13 patients recovered well,3 were moderately disabled,1 was severely disabled,1 vegetatively survived.ConclusionCoil embolization is a minimally invasive,safe and effective treatment method for patients with PCAs.