破裂椎动脉夹层动脉瘤早期介入栓塞治疗

R743; 目的:探讨破裂椎动脉夹层动脉瘤早期栓塞治疗方法及疗效.方法:22例破裂椎动脉夹层动脉瘤根据夹层动脉瘤形态以及与同侧小脑后下动脉(PICA)的关系,分别采用支架结合弹簧圈栓塞5例(其中2个以上支架叠加4例),单纯双支架治疗1例；弹簧圈闭塞近端椎动脉1例,动脉瘤及载瘤动脉闭塞15例.术后腰大池引流血性脑脊液,预防脑血管的痉挛.结果:本组22例患者中17例实施急诊手术(术中均未见出血和梗塞),5例限期手术；支架置入术6例,其中1例术后早期出现非动脉瘤性出血,但术后均恢复良好.单纯弹簧圈闭塞术16例,术后2例出现后组颅神经麻痹症状,1例高龄Ⅳ级患者放弃治疗出院.随访3个月-18个月,期间无...

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Published in浙江大学学报（医学版） Vol. 41; no. 1; pp. 93 - 98
Main Authors 许璟, 李吻, 陈贤谊, 蒋定尧, 张建民
Format Journal Article
LanguageChinese
Published 浙江大学医学院附属第二医院,浙江杭州,310009 2012
Subjects
血管造影术,数字减影
椎动脉
支架
动脉瘤,夹层/外科学
栓塞,治疗性/方法
动脉瘤,破裂/外科学
Online AccessGet full text
ISSN1008-9292
DOI10.3785/j.issn.1008-9292.2012.01.016

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Abstract R743; 目的:探讨破裂椎动脉夹层动脉瘤早期栓塞治疗方法及疗效.方法:22例破裂椎动脉夹层动脉瘤根据夹层动脉瘤形态以及与同侧小脑后下动脉(PICA)的关系,分别采用支架结合弹簧圈栓塞5例(其中2个以上支架叠加4例),单纯双支架治疗1例；弹簧圈闭塞近端椎动脉1例,动脉瘤及载瘤动脉闭塞15例.术后腰大池引流血性脑脊液,预防脑血管的痉挛.结果:本组22例患者中17例实施急诊手术(术中均未见出血和梗塞),5例限期手术；支架置入术6例,其中1例术后早期出现非动脉瘤性出血,但术后均恢复良好.单纯弹簧圈闭塞术16例,术后2例出现后组颅神经麻痹症状,1例高龄Ⅳ级患者放弃治疗出院.随访3个月-18个月,期间无再出血及脑梗塞发生,1例遗有后组颅神经麻痹症状；影像学随访14例,其中3例多支架结合弹簧圈栓塞治疗的载瘤动脉通畅、动脉瘤消失,11例动脉瘤及载瘤动脉闭塞的无再通,对侧椎动脉造影显示动脉瘤不显影.结论:破裂椎动脉夹层动脉瘤应尽早介入栓塞治疗.根据具体情况选择不同介入方法安全有效,双支架结合弹簧圈栓塞治疗方法应首先考虑.
AbstractList R743; 目的:探讨破裂椎动脉夹层动脉瘤早期栓塞治疗方法及疗效.方法:22例破裂椎动脉夹层动脉瘤根据夹层动脉瘤形态以及与同侧小脑后下动脉(PICA)的关系,分别采用支架结合弹簧圈栓塞5例(其中2个以上支架叠加4例),单纯双支架治疗1例；弹簧圈闭塞近端椎动脉1例,动脉瘤及载瘤动脉闭塞15例.术后腰大池引流血性脑脊液,预防脑血管的痉挛.结果:本组22例患者中17例实施急诊手术(术中均未见出血和梗塞),5例限期手术；支架置入术6例,其中1例术后早期出现非动脉瘤性出血,但术后均恢复良好.单纯弹簧圈闭塞术16例,术后2例出现后组颅神经麻痹症状,1例高龄Ⅳ级患者放弃治疗出院.随访3个月-18个月,期间无再出血及脑梗塞发生,1例遗有后组颅神经麻痹症状；影像学随访14例,其中3例多支架结合弹簧圈栓塞治疗的载瘤动脉通畅、动脉瘤消失,11例动脉瘤及载瘤动脉闭塞的无再通,对侧椎动脉造影显示动脉瘤不显影.结论:破裂椎动脉夹层动脉瘤应尽早介入栓塞治疗.根据具体情况选择不同介入方法安全有效,双支架结合弹簧圈栓塞治疗方法应首先考虑.
Author 李吻
陈贤谊
蒋定尧
许璟
张建民
AuthorAffiliation 浙江大学医学院附属第二医院,浙江杭州,310009
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CHEN Xian-yi
ZHANG Jian-ming
XU Jing
JIANG Ding-yao
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Keywords 血管造影术,数字减影
椎动脉
支架
动脉瘤,夹层/外科学
栓塞,治疗性/方法
动脉瘤,破裂/外科学
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Title 破裂椎动脉夹层动脉瘤早期介入栓塞治疗
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