颅内后循环动脉瘤的血管内介入治疗

目的总结颅内后循环动脉瘤的特点,探讨其血管内介入治疗的临床疗效。方法回顾性分析40例行血管内介入治疗的颅内后循环动脉瘤患者的临床和影像学资料、介入治疗过程,观察期效果及术后随访结果。结果 40例患者共发现42个后循环动脉瘤,均完成血管内介入治疗,其中8个行单纯弹簧圈栓塞,28个行支架辅助栓塞,1个行Onyx胶栓塞,5个动脉瘤及载瘤动脉同时闭塞。术后即刻DSA造影显示动脉瘤完全栓塞30个,近全栓塞6个,部分栓塞6个。术后6个月随访DSA造影显示动脉瘤完全栓塞36个,近全栓塞4个,部分栓塞1个。患者出院时行改良Rankin量表(mRS)评分,0分35例,1分3例,2分1例,1例死亡为6分;出院后3~6个月随访mRS评分0分38例,1分1例,无动脉瘤复发及新发神经功能障碍病例。结论颅内后循环动脉瘤具有特殊的临床与影像学表现,且复杂动脉瘤较为常见,对于颅内后循环动脉瘤,血管内介入治疗是一种安全有效的治疗方法。

Endovascular treatment of intracranial posterior circulation aneurysms

Objective To investigate the characteristics of intracranial posterior circulation aneurysms, and to evaluate the clinical outcomes of interventional endovascular therapy. Methods The clinical and imaging data, interventional therapy and observed effect, postoperative follow-up results of 40 patients with intracranial posterior circulation aneurysms treated with interventional endovascular therapy were analyzed retrospectively. Results Forty-two posterior circulation aneurysms were detected in 40 patients, and were treated successfully. Endovascular treatments included simple coil embolization (n=8), stent-assisted coil embolization (n=28), simple Onyx embolotherapy (n=1), aneurysms and parent artery occlusion (n=5). DSA performed immediately after treatment revealed that complete occlusion were achieved in 30 aneurysms, nearly complete occlusion in 6 aneurysms and partial occlusion in 6 aneurysms. DSA performed 6 months after treatment revealed that complete occlusion were achieved in 36 aneurysms, nearly complete occlusion in 4 aneurysms and partial occlusion in 1 aneurysms. At the time of discharge, the modified Rankin scale (mRS) scores were 0 point in 35 patients, 1 point in 3 patients, 2 point in 1 patient and 6 point in 1 dead patient. Three to six months after discharge from hospital, the mRS scores were 0 point in 38 patients and 1 point in 1 patient. No new neurological dysfunction or aneurysms recurred. Conclusion The intracranial posterior circulation aneurysms have special clinical and imaging features, and most of intracranial posterior circulation aneurysms are complex. Endovascular treatment is safe and effective for the intracranial posterior circulation aneurysms.