46例基底动脉顶端动脉瘤的血管内栓塞治疗

发布时间：2018-11-03 08:49

【摘要】：目的： 回顾性分析46例基底动脉顶端动脉瘤的血管内栓塞治疗结果，探讨基底动脉顶端动脉瘤血管内栓塞治疗的安全性和有效性。 方法： 收集吉林大学第一医院神经血管病外科自2005年7月至2013年12月期间收住的53例基底动脉尖部动脉瘤的临床资料并进行分析，其中46例均行血管内栓塞治疗。 结果： 46例患者均成功的进行了血管内栓塞治疗，男16例，女30例。年龄25～72岁，平均48.5岁。所有患者均行CTA、MRA或DSA检查明确诊断为基底动脉顶端动脉瘤。46例中合并其他血管病18例，其中合并后交通动脉瘤8例，合并大脑中动脉动脉瘤4例，合并烟雾病6例。40例动脉瘤破裂者均行头颅CT检查，显示不同程度蛛网膜下腔出血，其中4例合并脑室出血。动脉瘤直径2~11mm，其中5mm16例，5~10mm26例，10mm4例。宽颈动脉瘤(瘤颈≥4mm或者瘤颈：瘤体≥1：2)36例。未破裂动脉瘤6例，破裂动脉瘤40例。临床表现主要症状：头痛、恶心、呕吐35例，突发意识不清5例，突发头晕伴肢体功能障碍4例，无症状体检意外发现2例，Hunt-HessI～II级39例，Hunt-Hess III～V级5例。1例术中出现出血，其余均成功栓塞。其中单纯弹簧圈栓塞8例、支辅助栓塞38例，动脉瘤100％栓塞36例（78．2％)，90％以上栓塞8例(17．3％)，90％以下栓塞2例(4．3％)。并发基底动脉尖综合症1例，无死亡。出院时GOS评分为5分42例；4分4例。术后随访6个月到22个月，平均（16.6±2.8）个月，39例同栓塞当时相比无变化，5例复发，1例随访1年后死亡，失访1例。 结论： 血管内栓塞治疗是基底动脉尖部动脉瘤安全有效的治疗方法，并发症相对少，，治疗效果良好，患者致残致死率低，但是同时存在潜在风险，如出现痉挛、缺血，否则后果严重。
[Abstract]:Objective: to retrospectively analyze the results of endovascular embolization of 46 cases of aneurysms at the top of the basilar artery, and to explore the safety and efficacy of endovascular embolization of the apical aneurysms of the basilar artery. Methods: the clinical data of 53 cases of basilar artery apex aneurysms collected from July 2005 to December 2013 in the Department of Neuroangiopathy in the first Hospital of Jilin University were collected and analyzed. Among them 46 cases were treated with endovascular embolization. Results: 46 patients were successfully treated by endovascular embolization, including 16 males and 30 females. The average age was 48.5 years. All the patients were diagnosed by CTA,MRA or DSA. Among 46 cases, 18 cases were complicated with other angiopathy, including 8 cases with posterior communicating artery aneurysm, 4 cases with middle cerebral artery aneurysm, 4 cases with posterior communicating artery aneurysm, 4 cases with middle cerebral artery aneurysm, 8 cases with posterior communicating artery aneurysm and 4 cases with middle cerebral artery aneurysm. 6 cases were complicated with moyamoya disease. 40 cases of ruptured aneurysm were examined by CT, which showed subarachnoid hemorrhage of different degree, 4 of which were complicated with ventricular hemorrhage. The diameter of aneurysm was 2mm, including 5mm16, 5~10mm26 and 10mm4. 36 patients with wide neck aneurysm (neck 鈮

本文编号：2307293