[1]吴德刚 李真保 赵心同 袁金龙 秦飞云 盛　斌 张兵兵 方兴根.大脑前动脉A1段动脉瘤的血管内治疗[J].中国临床神经外科杂志,2017,(10):680-683.[doi:10.13792017.09/j.issn.1009-153X.2017.10.003]
　WU De-gang,LI Zhen-bao,ZHAO Xin-tong,et al.Endovascular treatment of aneurysms of proximal segments (A1) of anterior cerebral arteries[J].,2017,(10):680-683.[doi:10.13792017.09/j.issn.1009-153X.2017.10.003]
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大脑前动脉A1段动脉瘤的血管内治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年10期
页码:
680-683
栏目:
论著
出版日期:
2017-10-25

文章信息/Info

Title:
Endovascular treatment of aneurysms of proximal segments (A1) of anterior cerebral arteries
文章编号:
1009-153X（2017）10-0680-04
作者:
吴德刚 李真保 赵心同 袁金龙 秦飞云 盛　斌 张兵兵 方兴根
241001 安徽芜湖，皖南医学院附属弋矶山医院神经外科
Author(s):
WU De-gang;  LI Zhen-bao;  ZHAO Xin-tong;  YUAN Jin-long;  QIN Fei-yun;  SHEN Bin;  ZHANG Bing-bing;  FANG Xin-gen
Department of Neurosurgery, Affiliated Yijishan Hospital, Wannan Medical College, Wuhu 241001, China
关键词:
颅内动脉瘤; 大脑前动脉A1段; 血管内治疗; 疗效
Keywords:
Aneurysms;  ACA A1 segment;  Endovascular embolization;  Coils;  Curative effects
分类号:
R 743.9; R 815.2
DOI:
10.13792017.09/j.issn.1009-153X.2017.10.003
文献标志码:
A
摘要:
目的 探讨大脑前动脉A1段动脉瘤的血管内治疗方法及临床疗效。方法 回顾性分析2013年4月至2017年2月采用血管内方法治疗的25例大脑前动脉A1段动脉瘤的临床资料，15例采用单纯弹簧圈栓塞，5例采用支架辅助弹簧圈栓塞，1例A1段宽颈动脉瘤合并烟雾综合征予以球囊辅助栓塞，1例微小动脉瘤使用2枚enterprise支架重叠释放置入，3例行弹簧圈闭塞载瘤动脉。结果 术后即刻造影显示：Raymond分级Ⅰ级19例，Ⅱ级5例，Ⅲ级1例；无弹簧圈突入载瘤血管、术中动脉瘤破裂及支架内血栓形成等并发症。出院时，改良Rankin量表（mRS）评分0分17例，1分5例，2分1例，4分2例。16例术后临床和影像学随访3~24个月，未出现再出血和脑缺血并发症，mRS评分0分11例，1分3例，2分1例；2例复发，均为单纯弹簧圈填塞的动脉瘤，继续行支架辅助弹簧圈栓塞，术后无并发症。结论 血管内方法治疗大脑前动脉A1段动脉瘤安全有效，为保证成功栓塞，需要结合各种辅助技术和方法，其远期疗效需要进一步随访。
Abstract:
Objective To explore the methods to treat the aneurysms of the proximal segment (A1) of the anterior cerebral arteries (ACA) by endovascular embolization and its effects. Methods The clinical data of 25 patients with ACA A1 segment aneurysms, who underwent endovascular embolization from April, 2013 to February, 2017, were analyzed retrospectively. The curative effects were evaluated by Raymond grading immediately after the embolization. The intraoperative and postoperative complications were observed and 16 patients were followed up by clinical and imaging methods from 3 to 24 months after the operation. Results Of 25 patients, 15 were treated by pure coils embolization, 5 by stent-assisted coils embolization, 3 by the occlusion of the parent arteries with coils, 1 by stent implantation and 1 by balloon-assisted embolization. The outcomes were Raymond grade Ⅰ in 19 patients, grade Ⅱ in 5 and grade Ⅲ in 1 immediately after the embolization. There were no complications, such as coils protrusion into the parent arteries, aneurysmal rupture, intrastent thrombosis and so on in all the patients. The following-up data showed that no rebleeding and cerebral ischemic complications were observed. The prognoses were modified Rankin scale 0 point in 12 patients, 1 point in 3 and 2 points in 1. Two patients with recurrent aneurysms were cured after stent-assisted coils embolization. Conclusions The endovascular embolization of the A1 segments aneurysms of the ACA is safe and effective. The various ancillary techniques and methods are necessary for the operator to ensure the successful embolization. The long-term effects of the endovascular embolization on ACA A1 segments aneurysms should be further observed.

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备注/Memo

备注/Memo:
作者单位：241001 安徽芜湖，皖南医学院附属弋矶山医院神经外科（吴德刚、李真保、赵心同、袁金龙、秦飞云、盛　斌、张兵兵、方兴根）通讯作者：方兴根，E-mail:18805536056@163.com
更新日期/Last Update: 1900-01-01