[1]明智绪 冯 进 朱辰路 杨振兴 李曦男 颜 华 黄德俊 李宗正.颈内动脉眼动脉段动脉瘤的血管内治疗[J].中国临床神经外科杂志,2018,(08):543-546.[doi:doi:10.13798/j.issn.1009-153X.2018.08.011]
 Endovascular embolization treatment of ophthalmic artery aneurysms (report of cases).Endovascular embolization treatment of ophthalmic artery aneurysms (report of 36 cases)[J].,2018,(08):543-546.[doi:doi:10.13798/j.issn.1009-153X.2018.08.011]
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颈内动脉眼动脉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:
2018年08期
页码:
543-546
栏目:
论著
出版日期:
2018-08-25

文章信息/Info

Title:
Endovascular embolization treatment of ophthalmic artery aneurysms (report of 36 cases)
文章编号:
1009-153X(2018)08-0543-04
作者:
明智绪 冯 进 朱辰路 杨振兴 李曦男 颜 华 黄德俊 李宗正
作者单位:750004 银川,宁夏医科大学总医院神经外科(明智绪、冯进、朱辰路、杨振兴、李曦男、颜 华、黄德俊、李宗正)
Author(s):
Endovascular embolization treatment of ophthalmic artery aneurysms (report of 36 cases)
Department of Neurosurgery, General Hospital, Ningxia Medical University, Yinchuan 750004, China
关键词:
颅内动脉瘤颈内动脉 眼动脉段血管内栓塞疗效
Keywords:
Ophthalmic artery aneurysms Endovascular embolization Outcome Recurrence
分类号:
R 743.9; R 815.2
DOI:
doi:10.13798/j.issn.1009-153X.2018.08.011
文献标志码:
A
摘要:
目的 探讨颈内动脉眼动脉段动脉瘤血管内治疗的疗效。方法 回顾性分析2012年9月至2017年11月宁夏医科大学总医院神经外科应用血管内栓塞治疗的36例颈内动脉眼动脉段动脉瘤的临床资料。结果 36例共44枚动脉瘤,其中采用单纯弹簧圈栓塞10枚,LVIS支架辅助栓塞13枚,Enterprise支架辅助栓塞19枚,Neuroform支架辅助栓塞2枚。术后即刻DSA显示Roymond分级Ⅰ级22枚,Ⅱ 级20枚,Ⅲ级2枚;栓塞有效率为95.5%。2例栓塞术中发生血栓事件,2例术中动脉瘤破裂,1例术后动脉瘤2次破裂。术后随访4~19个月,改良Rankin量表评分0~2分32例,3~6分4例。30例(34枚)DSA复查,6枚复发。结论 血管内栓塞治疗颈内动脉眼动脉段动脉瘤安全有效,积极预防及治疗并发症可改善预后,但需长期随访观察复发情况。
Abstract:
Objective To explore experience in endovascularly treating ophthalmic artery aneurysms, operative complication and the curative effects. Methods The clinical data of 36 patients with 44 ophthalmic artery aneurysms, who were treated by endovascular embolization in our deparment from September, 2012 to October, 2017, were analyzed retrospectively. Results Of these 44 aneurysms, 10 were successfully embolized only with coils, 13 with LVIS stent-assisted coils, 19 with Enterprise stent-assisted coils and 2 with Neuroform stent-assisted coils. DSA immediately after the embolization showed that 22 received Raymond grade Ⅰ occlusion (complete occlusion), 20 Raymond grade Ⅱ(residual aneurysm neck) and 2 Raymond grade Ⅲ (residual aneurysm). The effective rate of endovascular embolization was 95.5% (42/44). Thrombosis was observed in 2 and aneurysms ruptured in 2 cases. Aneurysm ruptured in 1 case after endovascular embolization. The following up for 4~19 months after the embolization showed that according to modified Rankin scale, the curative effects were good in 32 cases (88.9%, 32/36) and bad in 4 cases. The aneurysms recurred in 6 of 30 followed up with DSA 4~9 months after the embolization. Conclusions The endovascular embolization is a safe and effective method to treat the ophthalmic artery aneurysms. The prevention and treatment of complications can improve curative outcome, but the problem of aneurysm recurrence need long-term observing.

参考文献/References:

[1] 杨 杰,管 生,徐浩文,等. 眼动脉段动脉瘤血管内栓塞 治疗方法探讨[J]. 介入放射学杂志,2016,25:750-754.
[2] 李修修,吴日乐,纪文军,等. 颈内动脉眼动脉段未破裂动 脉瘤支架辅助栓塞治疗的随访分析[J]. 中国脑血管病杂 志,2016,13(4):187-190.
[3] Yeon JY, Hong SC, Kim JS, et al. Unruptured nonbranching site aneurysms located on the anterior(dorsal) wall of the supraclinoid internal carotiod artery: aneurismal charac- teristics and outcomes following endovascular treatment [J]. Acta Neurochir (Wien), 2012, 154(12): 2163-2171.
[4] Lngd S, Rosch J, Golitz P, et al. Comparison of intracranial aneurysms treated by 2d versus 3d coils: a matchedpairs analysis [J]. Clin Neuroradiol, 2017, 27(1): 43-49.
[5] Chaudry I, Frei D, Baxter B, et al. E-037 Initial Multi- Centre Experience with the Penumbra PC 400 Detachable Coilin aneurysms 10 mm or greater [J]. J Neurointerv Surg, 2013, 5(Suppl 2): A50-A50.
[6] Machi P, Costalat V, Lobotesis K, et al. LEO baby stent use following balloon-assisted coiling: single-and dual-stent technique-immediate and midterm results of 29 consecutive atients [J]. Am J Neuroradiol, 2015, 36(11): 2096-2103.
[7] Gentric JC, Biondi A, Piotin M, et al. Balloon remodeling may improve angiographic results of stent-assisted coiling of unruptured intracranial aneurysms [J]. Neurosurgery, 2015, 76(4): 441-445.
[8] Ahn JH, Cho YD, Kang HS, et al. Endovascular treatment of ophthalmic artery aneurysms: assessing balloon test occlu- sion and preservation of vision in coil embolization [J]. Am J Neuroradiol, 2014, 35(11): 2146-2152.
[9] Chien A, Vinuela F, Duckwiler G, et al. Blood flow changes induced by flow diverting stent in a large wide-neck intra- cranial aneurysm [J]. J Vasc Interv Radiol, 2015, 26(1): 146-149.
[10] 王爱平,王昆鹏,孙瑞迅,等. 93例颅内动脉瘤血管内介 入治疗的临床分析[J]. 中华神经外科杂志,2013,29(3): 243-245.
[11] Zanaty M, Chalouhi N, Barros G, et al. Flow-Diversion for ophthalmic segment aneurysms [J]. Neurosurgery, 2015, 76 (3): 286-290.
[12] Moon K, Albuquerque FC, Ducruet AF, et al. Treatment of ophthalmic segment carotid aneurysms using the pipeline embolization device: clinical and angiographic follow-up [J]. Neurol Res, 2014, 36(4): 344-350.
[13] Dashti SR1, Friedman WA. Hyponatremia in neurosurgical patients: clinical guidelines development [J]. Neurosurgery, 2009, 65(5): 925-935.
[14] Lü N, Zhao R, Yang P, et al. Predictors of recurrence after stentassisted coil embolization of paraclinoid aneurysms [J]. J Clin Neurosci, 2016, 33: 173-176.

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备注/Memo

备注/Memo:
通讯作者:李宗正,E-mail:nxlizongzh@163.com
更新日期/Last Update: 2018-09-07