椎-基底小型夹层动脉瘤单纯支架治疗探讨
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摘要
目的探讨单纯支架植入治疗小型椎-基底动脉夹层动脉瘤的可行性及优越性。方法对采取单纯支架植入治疗小型椎-基底动脉夹层动脉的16例患者临床资料进行回顾性分析。结果16例患者临床症状均有好转。术后造影:所有支架位置准确,在夹层动脉瘤段释放到位;16例病例均明显造影剂滞留。16例患者术后7 d内均出院,并进行随访3~18个月,平均随访时间为13个月。影像学随访:16例患者均治愈,夹层动脉瘤未显影,动脉支架安放段均通畅,未出现血栓或出血以及后循环供血障碍等并发症。结论单纯支架植入的方法治疗椎-基底动脉瘤,从支架植入前后影像对比,以及术后临床症状、造影的随访资料分析,单纯支架植入是治疗椎-基底动脉夹层动脉瘤的安全、有效的方法。
Objective The feasibility and advantages of using the sole stenting implantation technique in the treatment of dissecting aneurysm of the small vertebrobasilar artery were discussed. Methods The clinical data of 16 cases of dissecting aneurysm of the small vertebrobasilar artery which were treated by the sole stenting implantation technique were reviewed retrospectively. Results The clinical symptoms of all 16 cases had been relieved. The postoperative angiography showed the stents had been precisely delivered and deployed in the dissecting aneurysm segment and the filling of contrast had been delayed significantly in all 16 cases. All patients in 16 cases had been discharged within 7 days,and were followed up with a range from 3 to 18 months( average 13 months). The radiography follow-up indicated that the outcomes of all patients in 16 cases were cured. All the dissecting aneurysm did not develop with the contrast. The blood flow of the dissecting aneurysm segment where the stent had been implanted was sufficient and no post-operative complications such as thrombosis,hemorrhage or disturbance of blood supply of the posterior part of the Willis circle had been observed. Conclusion Based on the analysis of the postoperative radiography study,the improvements of clinical symptoms and the radiography follow-up study,the sole stenting implantation technique is proven to be safe and effective in the treatment of dissecting aneurysm of the vertebrobasilar artery.
Objective The feasibility and advantages of using the sole stenting implantation technique in the treatment of dissecting aneurysm of the small vertebrobasilar artery were discussed. Methods The clinical data of 16 cases of dissecting aneurysm of the small vertebrobasilar artery which were treated by the sole stenting implantation technique were reviewed retrospectively. Results The clinical symptoms of all 16 cases had been relieved. The postoperative angiography showed the stents had been precisely delivered and deployed in the dissecting aneurysm segment and the filling of contrast had been delayed significantly in all 16 cases. All patients in 16 cases had been discharged within 7 days,and were followed up with a range from 3 to 18 months( average 13 months). The radiography follow-up indicated that the outcomes of all patients in 16 cases were cured. All the dissecting aneurysm did not develop with the contrast. The blood flow of the dissecting aneurysm segment where the stent had been implanted was sufficient and no post-operative complications such as thrombosis,hemorrhage or disturbance of blood supply of the posterior part of the Willis circle had been observed. Conclusion Based on the analysis of the postoperative radiography study,the improvements of clinical symptoms and the radiography follow-up study,the sole stenting implantation technique is proven to be safe and effective in the treatment of dissecting aneurysm of the vertebrobasilar artery.
引文
1 马廉亭.颅内动脉夹层与夹层动脉瘤的诊断与治疗[J].中国临床神经外科杂志,2008,13(10):577-578.
2 吴中学,刘爱华,李佑祥,等.支架技术在椎动脉梭形及夹层动脉瘤的应用[J].介入放射学杂志,2004,S1:18-20.
3 赵文元,刘建民,许奕,等.颅内椎动脉夹层动脉瘤的介入治疗[J].介入放射学杂志,2003,12(3):173-175.
4 Hosoya T,Adachi M,Yamaguchi K,et al.Clinical and neuroradiological features of intracranial vertebrobasilar artery dissection[J].Stroke,1999,30(5):1083-1090.
5 杨铭.颅内动脉夹层动脉瘤[J].中国临床神经外科杂志,2013,18(8):505-508.
2 吴中学,刘爱华,李佑祥,等.支架技术在椎动脉梭形及夹层动脉瘤的应用[J].介入放射学杂志,2004,S1:18-20.
3 赵文元,刘建民,许奕,等.颅内椎动脉夹层动脉瘤的介入治疗[J].介入放射学杂志,2003,12(3):173-175.
4 Hosoya T,Adachi M,Yamaguchi K,et al.Clinical and neuroradiological features of intracranial vertebrobasilar artery dissection[J].Stroke,1999,30(5):1083-1090.
5 杨铭.颅内动脉夹层动脉瘤[J].中国临床神经外科杂志,2013,18(8):505-508.