后循环动脉瘤的血管内介入治疗

目的探讨后循环动脉瘤血管内介入治疗的临床应用。方法 14例后循环动脉瘤患者Hunt&Hess分级分为Ⅱ级11例,Ⅲ级2例,Ⅳ级1例;数字减影血管造影(DSA)显示椎动脉瘤2例,小脑后下动脉远端动脉瘤5例,基底动脉尖动脉瘤2例,基底动脉末端动脉瘤1例,小脑前下动脉瘤2例,大脑后动脉瘤2例。入组者均给予血管内介入治疗,其中7例囊性动脉瘤采用单纯弹簧圈栓塞术,5例采用Onxy胶载瘤动脉局部栓塞术,分别有1例应用支架辅助微弹簧圈栓塞术及支架塑形术。结果术后DSA显示动脉瘤完全栓塞10例,近全栓塞3例。1例支架塑形术后梭形膨出明显好转。格拉斯哥预后量表评分为5分12例,3分1例,2分1例。随访3个月～5年,8例恢复正常,1例左侧偏瘫,1例死亡,4例失访。结论颅内后循环动脉瘤多为复杂动脉瘤,个体化血管内介入治疗是安全、有效的方法。

Interventional endovascular therapy on posterior circulation aneurysms

Objective To explore the clinical application of interventional endovascular therapy on posterior circulation aneurysms(PCA).Methods Fourteen PCA patients were graded into Ⅱgrade in 11 cases,Ⅲ grade in 2 cases and Ⅳ grade in 1 case according to Hunt & Hess classification.Digital subtraction angiography(DSA) showed that there were vertebral aneurysm in 2 case,distal aneurysms of posterior inferior cerebellar artery in 5 cases,top basilar artery aneurysms in 2 cases,terminal aneurysm of basilar artery in 1 case,anterior inferior cerebellar artery aneurysms in 2 cases and posterior cerebral artery aneurysms in 2 cases.All of the PCA patients received the interventional endovascular therapy,including applied pure coil embolization in 7 cases with saccular aneurysms,local parent artery Onxy glue embolization in 5 cases,stent-assisted coil embolization and stent shapping in 1 case respectively.Results After the operation,DSA showed that the aneurysms were completely embolized in 10 cases,subtotally embolized in 3 cases.And in 1 case,the fusiform intamescentia was significantly improved after stent shaping.The score of Glasgow outcome scale was 5 points in 12 cases,3 points in 1 cases and 2 points in 1 cases.Followed-up 3 months to 5 years,the 8 cases were recover very well,1 case was hemiplegia and 1 case dead;4 cases were lost to followed-up.Conclusions Mostly of intracranial posterior circulation aneurysms are complex aneurysm.The therapy of individual endovascular interventional is safe and effective.