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Received:May 24, 2022 Published Online:August 20, 2023
Received:May 24, 2022 Published Online:August 20, 2023
中文摘要: 目的探讨血管内介入栓塞治疗小脑后下动脉(PICA)破裂动脉瘤的安全性和有效性。方法回顾性分析2014年6月至2021年8月南京市第一医院收治的18例PICA破裂动脉瘤患者的临床资料。结果18例患者术后即刻造影显示Raymond分级Ⅰ级致密栓塞14例(77.78%),Ⅱ级瘤颈残余2例(11.11%),Ⅲ级瘤体残余2例(11.11%)。围手术期并发症2例(11.11%),1例脑干、小脑梗死致死,死亡率5.56%;1例(5.56%)破裂动脉瘤患者术中动脉瘤再次破裂。除1例死亡患者外,17例患者术后mRS评分均≤3分,预后良好率94.44%(17/18)。17例患者术后随访6~12个月,2例经单纯弹簧圈栓塞患者PICA瘤颈复发,复发率11.11%(2/18),其中1例接受LVIS双支架治疗后治愈。结论血管内栓塞介入治疗PICA动脉瘤是安全有效的方法,治疗策略的设计应综合考虑动脉瘤和载瘤动脉的位置、形态特征而定。
Abstract:ObjectiveTo investigate the safety and efficacy of endovascular embolization for ruptured posterior inferior cerebellar artery (PICA) aneurysms. MethodsThe clinical data of 18 patients with ruptured PICA aneurysms admitted in Nanjing First Hospital from June 2014 to August 2021 were retrospectively analyzed. ResultsImmediate postoperative angiography showed that 14 patients (77.78%) had Raymond grade Ⅰ dense embolism, 2 patients (11.11%) had Raymond grade Ⅱ residual tumor neck, and 2 patients (11.11%) had Raymond grade Ⅲ residual tumor. Perioperative complications occurred in 2 cases (11.11%), and cerebral stem and cerebellar infarction resulted in death in 1 case (5.56%). One patient (5.56%) with ruptured aneurysm ruptured again during the operation. Except for 1 died patient, the mRS scores of 17 patients were all ≤3 points, and the good prognosis rate was 94.44% (17/18). Seventeen patients were followed up for 6-12 months after operation, 2 patients with PICA tumor neck recurrence after simple coil embolization, the recurrence rate was 11.11% (2/18), one of them was cured by LVIS double stent treatment. ConclusionEndovascular embolization is a safe and effective method for the treatment of PICA aneurysms. The design of treatment strategy should be based on the location and morphological characteristics of the aneurysm and parent artery.
keywords: Posterior inferior cerebellar artery Aneurysm Interventional therapy Endovascular embolization
文章编号: 中图分类号:R732.2 文献标志码:B
基金项目:江苏省中医药科技项目(YB2020036)
Author Name | Affiliation |
CUI Sitong, MA Jun, LIU Zhen | Department of Neurosurgery, Nanjing First Hospital, Nanjing, Jiangsu 210006, China |
Author Name | Affiliation |
CUI Sitong, MA Jun, LIU Zhen | Department of Neurosurgery, Nanjing First Hospital, Nanjing, Jiangsu 210006, China |
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