支架辅助弹簧圈栓塞治疗破裂椎动脉夹层动脉瘤的疗效分析

发布时间：2018-09-19 09:23

【摘要】：目的:探讨支架辅助弹簧圈栓塞治疗破裂椎动脉夹层动脉瘤的安全性及有效性。方法:回顾性分析2011年1月至2016年10月在我院采用支架辅助簧圈栓塞治疗的30例破裂椎动脉夹层动脉瘤患者的临床表现、DSA表现、即刻栓塞程度、手术并发症及随访情况。结果:30例患者术中完全栓塞5例,接近完全栓塞6例,部分栓塞19例;术后1例患者死亡,1例患者术后出现造影剂脑病,其余无新发出血或者缺血并发症发生;DSA随访25例患者,随访时间6-24月(平均16个月),随访的4例完全栓塞患者表现稳定,随访的5例接近完全栓塞患者中1例表现为稳定,3例表现为改善,1例发生复发,随访的16例部分栓塞患者,6例表现为改善,7例稳定,3例复发;4例复发患者中,2例再次治疗,2例未治疗。29例患者临床随访2-62个月(平均26个月),27例患者临床结果和mRS评分恢复良好,造影剂脑病患者遗留阵发性心悸、出汗、右侧侧上肢麻木症状,2例患者遗留肢体功能障碍,mRS评分分别为2,4,2例患者的肌力较入院时均有不同程度的提高。结论:支架辅助弹簧圈栓塞治疗破裂椎动脉夹层动脉瘤显示出较好的安全性及有效性,多支架置入可能会降低术后复发风险,上述结论均需大样本研究进一步论证。
[Abstract]:Objective: to evaluate the safety and efficacy of stent-assisted coil embolization in the treatment of ruptured vertebral dissecting aneurysms. Methods: the clinical manifestations of 30 patients with ruptured vertebral artery dissecting aneurysms treated with stent assisted Reed coil embolization from January 2011 to October 2016 were retrospectively analyzed. Results complete embolization was found in 5 cases, close to complete embolization in 6 cases, partial embolization in 19 cases in 30 cases, contrast encephalopathy in 1 case died after operation, and 25 cases were followed up with DSA without new bleeding or ischemic complications. The follow-up time was 6-24 months (mean 16 months), 4 cases of complete embolism were stable, and 1 case of 5 cases of close to complete embolism showed stability, 3 cases showed improvement and 1 case recurred. Of the 16 cases of partial embolism followed up, 6 cases showed improvement in 7 cases of stable embolism, 3 cases of recurrence and 4 cases of recurrence. 2 cases were treated again. 29 cases were followed up for 2 to 62 months (mean 26 months), 27 cases were followed up, and 2 cases were followed up for 2 to 62 months (mean 26 months), and 2 cases were followed up for 2 to 62 months (mean, 26 months). The mRS score recovered well, The left limb dysfunction in 2 patients with paroxysmal palpitation, sweating and numbness of the right upper extremity were 2 ~ 4%, respectively. The muscle strength of 2 cases was improved in different degree than that on admission. Conclusion: stent assisted coils embolization for ruptured vertebral dissecting aneurysms is safe and effective, and multi-stent implantation may reduce the risk of postoperative recurrence.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12

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