[1]马亚伟　胡振坤　徐　睿等.支架辅助弹簧圈栓塞治疗大脑前动脉A1段起始处破裂微小动脉瘤[J].中国临床神经外科杂志,2021,26(03):145-148.[doi:10.13798/j.issn.1009-153X.2021.03.001]
　MA Ya-wei,HU Zhen-kun,XU Rui,et al.Stent-assisted coiling embolization for ruptured proximal anterior cerebral artery (A1) tiny aneurysms[J].,2021,26(03):145-148.[doi:10.13798/j.issn.1009-153X.2021.03.001]
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支架辅助弹簧圈栓塞治疗大脑前动脉A1段起始处破裂微小动脉瘤()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年03期
页码:
145-148
栏目:
论著
出版日期:
2021-03-25

文章信息/Info

Title:
Stent-assisted coiling embolization for ruptured proximal anterior cerebral artery (A1) tiny aneurysms
文章编号:
1009-153X（2021）03-0145-04
作者:
马亚伟　胡振坤　徐　睿等
400016 重庆，重庆医科大学附属第一医院神经外科（马亚伟、胡振坤、徐　睿、张晓冬、朱　继、孙晓川）
Author(s):
MA Ya-wei;  HU Zhen-kun;  XU Rui;  et al
Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
关键词:
颅内破裂动脉瘤; 微小动脉瘤; 大脑前动脉A1段; 支架; 栓塞
Keywords:
Intracranial ruptured aneurysm;  Anterior cerebral artery A1;  Intracranial tiny aneurysm;  Stent-assisted coiling
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2021.03.001
文献标志码:
A
摘要:
目的 探讨支架辅助弹簧圈栓塞治疗大脑前动脉A1段起始处破裂微小动脉瘤的安全性和有效性。方法 回顾性分析2010~2018年支架辅助弹簧圈栓塞治疗的11例大脑前动脉A1段起始处破裂微小动脉瘤的临床资料。结果 11例中，6例微导管塑形成“S”形，4例“Z”形，1例“猪尾形”。术后即刻造影显示，Raymond分级Ⅰ级9例，Ⅱ级2例。1例术后3 d出现缺血事件，出院时未遗留神经功能障碍。11例临床随访10~31个月，平均18.4个月，中位随访时间为17个月，随访期间无出血、缺血事件。11例术后6~12个月造影复查，Raymond分级Ⅰ级9例，Ⅱ级2例；临床随访改良Rankin量表评分0~2分9例，3分1例，4分1例。结论 支架辅助弹簧圈栓塞是一种治疗大脑前动脉A1段起始处破裂微小动脉瘤的安全、有效的方法。
Abstract:
Objective To explore the feasibility, effectiveness, and safety of the stent-assisted coiling embolization for the patients with ruptured proximal anterior cerebral artery (A1) tiny aneurysms. Methods The clinical data of 11 patients with ruptured proximal anterior cerebral artery (A1) tiny aneurysms who received stent-assisted coiling embolization from 2010 to 2018 were analyzed retrospectively. Results Patient-specific catheter shaping was performed in all the patients, of whom 6 were formed to "S" shape, 4 "Z" shape and 1"pig tail". Raymond grade Ⅰ was achieved in 9 patiens and grade Ⅱ in 2 immediately after the embolization. Ischemic event occurred in 1 patient 3 days after the operation, without neurological disorders on discharge. No ischemic events occurred in all the patients during the follow-up (range, 10~31 months; mean, 18.4 months; median, 17 months). The follow-up (range, 6~12 months) DSA images showed Raymond grade Ⅰ in 9 patiens and grade Ⅱ in 2. The outcomes of clinical follow-up (range, 6~12 months) showed modified Rankin scale score of 0~2 in 9 patients, 3 in 1, and 4 in 1. Conclusion Stent-assisted coiling embolization is a good and safe treatment method for the patients ruptured proximal anterior cerebral artery (A1) tiny aneurysms.

参考文献/References:

[1] Wang HW, Xue Z, Ma YD, et al. The special considerations in the surgical management of proximal anterior cerebral artery aneurysms [J]. World Neurosurg, 2019, 127(7): e761-e767.
[2] Molyneux AJ, Birks J, Clarke A, et al. The durability of endovascular coiling versus neurosurgical clipping of rup-tured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT) [J]. Lancet, 2015, 385(9969): 691-697.
[3] Waseem A, Ahmed I, Hadeel S. Endovascular management of microcerebral aneurysms with diameter smaller than 3 mm: is it feasible and safe [J]? J Stroke Cerebrovasc Dis, 2018, 27(6): 1590-1598
[4] Yamaki VN, Brinjikji W, Murad MH, et al. Endovascular treatment of very small intracranial aneurysms: meta-analysis [J]. AJNR Am J Neuroradiol, 2016, 37(5): 862-867.
[5] Zheng Y, Song Y, Liu D, et al. Stent-assisted coiling embo-lization of tiny, wide-necked intracranial aneurysms [J]. Acta Neurochir (Wien), 2017, 159(1): 93-100.
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备注/Memo

备注/Memo:
通讯作者：朱　继，E-mail：a68690569@sina.com
更新日期/Last Update: 2021-03-25