[1]蔡明俊　陈劲草　李正伟　杨　铭　马廉亭.颈内动脉颅外段严重迂曲病人颅内动脉瘤的血管内栓塞治疗分析[J].中国临床神经外科杂志,2017,(11):741-743.[doi:10.13798/j.issn.1009-153X.2017.11.003]
　CAI Ming-jun,CHEN Jin-cao,LI Zheng-wei,et al.Clinical analysis of interventional therapy for intracranial aneurysms in patients with severe tortuosity of extracranial internal carotid artery[J].,2017,(11):741-743.[doi:10.13798/j.issn.1009-153X.2017.11.003]
点击复制

颈内动脉颅外段严重迂曲病人颅内动脉瘤的血管内栓塞治疗分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年11期
页码:
741-743
栏目:
论著
出版日期:
2017-11-25

文章信息/Info

Title:
Clinical analysis of interventional therapy for intracranial aneurysms in patients with severe tortuosity of extracranial internal carotid artery
文章编号:
1009-153X（2017）11-0741-03
作者:
蔡明俊　陈劲草　李正伟　杨　铭　马廉亭
430071 武汉，汉大学中南医院神经外科（蔡明俊、陈劲草、李正伟）；430070 武汉，中国人民解放军武汉总医院神经外科（杨　铭、马廉亭）
Author(s):
CAI Ming-jun1;  CHEN Jin-cao1;  LI Zheng-wei1;  YANG Ming2;  MA Lian-ting2.
1. Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan 430071, China; 2. Department of Neurosurgery, Wuhan General Hospital, PLA, Wuhan 430070, China
关键词:
颅内动脉瘤; 颈内动脉迂曲; 血管内治疗; 疗效
Keywords:
Intracranial aneurysms;  Tortuosity;  Extracranial internal carotid artery;  Endovascular treatment
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2017.11.003
文献标志码:
A
摘要:
目的 探讨颈内动脉颅外段严重迂曲病人颅内动脉瘤进行血管内栓塞治疗的可行性及安全性。方法 回顾性分析2016年6月到2017年8月收治的11例颅内动脉瘤伴颈内动脉颅外段血管严重迂曲病人临床资料，均采用血管内栓塞治疗。结果 11例术后即刻DSA示动脉瘤消失，载瘤动脉通畅，无血管夹层、支架内血栓形成、术中动脉瘤破裂或脑梗死等并发症。11例出院后随访3~12个月，均无神经功能缺失表现。5例术后6个月复查DSA未见动脉瘤复发，载瘤动脉通畅。结论 伴颈内动脉颅外段严重迂曲的颅内动脉瘤，根据病人具体情况，在相关血管内技术的辅助下，进行栓塞治疗仍是一种相对可行、安全和有效的治疗手段。
Abstract:
Objective To investigate the feasibility and safety of endovascular embolization of intracranial aneurysms in patients with severe tortuosity of extracranial internal carotid arteries. Methods The clinical data of 11 intracranial aneurysm patients with severe tortuosity of extracranial internal carotid arteries diagnosed by DSA who underwent endovascular embolization in our hospital from June, 2016 to August, 2017 were analyzed retrospectively. Of these 11 patients, whose age ranged from 39 to 78 years old (mean, 51 years old), 5 were male and 6 female. All the patients were followed up from 3 to 9 months. Results All the patients were successfully treated with simple coils embolization technique or stent-assisted coiling technique. The intraoperative cerebrovascular spasm occurred in 2 patients. The other complications including intracranial hemorrhage, carotid artery dissection and transient ischemic attack did not occur in all the patients. No patients died or suffered from neurologic events in these 11 patients during the following-up. Conclusions The catheter insertion during the endovascular interventional treatment procedure is difficult in the intracraial aneurysms patients with severe tortuosity of the extracranial internal carotid arteries. However, the endovascular treatment is still a relatively feasible, safe and effective method to treat intracranial aneurysms in the patients with severe tortuosity of the extracranial internal carotid arteries who do not consent to craniotomy or had the contraindication of the craniotomy for the intracranial aneurysms.

参考文献/References:

[1] Metz H, Murray-Lesllie RM, Bannister RG, et al. Kinking of the internal carotid artery: in relation to cerebrovascular disease [J]. Lancet, 1961, 277(7174): 424-426.
[2] Beigelman R, Izaguirre AM, Robles M, et al. Are kinking and coiling of carotid artery congenital or acquired [J]. Angiology, 2010, 61(1): 107-112.
[3] Del CL, Moruzzo D, ConteB, et al. Tortuosity, kinking, and coiling of the carotid artery: expression of atherosclerosis or aging [J]. Angiology, 1998, 49(5): 361-371.
[4] 周华东，李惠允. 颈内动脉迂曲研究进展[J]. 解放军医药 杂志，2014，26（3）：31-34.
[5] 王利军，王大明，刘加春，等. 颈内动脉狭窄处扭曲的血管 内治疗[J]. 中华外科杂志，2011，49（2）：105-108.
[6] Togay-I?ikay C, Kim J, Betterman K, et al. Carotid artery tortuosity, kinking, coiling: stroke risk factor, marker, or curiosity [J]? Acta Neurol Belg, 2005, 105(2): 68-72. （2017-10-10收稿，2017-10-12修回）

相似文献/References:

[1]曾　春　张施远　蒋永明.复合手术与常规夹闭术治疗颈内动脉后交通动脉破裂动脉瘤的疗效对比研究[J].中国临床神经外科杂志,2016,(05):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
　ZENG Chun,ZHANG Shi-yuan,JIANG Yong-ming.Analysis of the effects of hybrid surgery on posterior communicating artery aneurysms: a comparison with conventional craniotomy[J].,2016,(11):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
[2]周有东　敖祥生　刘汉东　王志勇　朱耀祖　周达全.支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析[J].中国临床神经外科杂志,2016,(05):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
　ZHOU You-dong,AO Xiang-sheng,LIU Han-dong,et al.A mata-analysis of curative effects of stent-assisted coiling and simple coiling on intracranial aneurysms and their safety[J].,2016,(11):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
[3]赵　平　王雄伟　汪　雷　马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
　ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(11):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
[4]李朝晖　王玉贵　张孟超 综述　赵兴利 审校.CT灌注成像在动脉瘤性蛛网膜下腔出血中的 临床应用进展[J].中国临床神经外科杂志,2016,(05):313.[doi:10.13798/j.issn.1009-153X.2016.05.021]
[5]刘福德　邓剑平　张　涛　陈　虎　李　帅　王俭博　曲友直　赵振伟.椎-基底动脉夹层动脉瘤的血管内治疗（附48例分析）[J].中国临床神经外科杂志,2016,(06):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
　LIU Fu-de,DENG Jian-ping,ZHANG Tao,et al.Endovascular treatment of vertebrobasilar artery dissecting aneurysms (report of 48 cases)[J].,2016,(11):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
[6]吴有志　罗良生　张　健　陈　骅　吴　鸣　刘　振　史　岩.前循环破裂动脉瘤伴脑内血肿的 早期显微手术治疗[J].中国临床神经外科杂志,2016,(06):376.[doi:10.13798/j.issn.1009-153X.2016.06.020]
[7]潘　力　刘　鹏　秦　杰　杨　柳　安学峰　吴　虓　杨　铭　徐国政　马廉亭.Y型支架辅助技术在颅内动脉分叉部宽颈动脉瘤治疗中的应用[J].中国临床神经外科杂志,2016,(07):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
　PAN Li,LIU Peng,QIN Jie,et al.Application of Y -configuration stent technique to treatment of intracranial wide-neck bifurcation aneurysms[J].,2016,(11):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
[8]周　量　刘　丛　张昌伟.早期栓塞术治疗动脉瘤性蛛网膜下腔出血的疗效[J].中国临床神经外科杂志,2016,(07):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
　ZHOU Liang,LIU Cong,ZHANG Chang-wei..Curative effect of early endovascular embolization on patients with ruptured intracranial aneurysms[J].,2016,(11):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
[9]张　莹　荆林凯　张倩倩　刘　健　张义森　王　坤　穆士卿　杨新健.颈内动脉后交通动脉小动脉瘤破裂危险因素分析[J].中国临床神经外科杂志,2016,(03):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
　ZHANG Ying,JING Lin-kai,ZHANG Qian-qian,et al.Analysis of risk factors related to rupture of small (diameter ≤5 mm) posterior communicating artery aneurysms[J].,2016,(11):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
[10]朱作磊 综述　罗良生 审校.动脉瘤性蛛网膜下腔出血的预后相关因素研究进展[J].中国临床神经外科杂志,2016,(03):183.[doi:10.13798/j.issn.1009-153X.2016.03.020]

更新日期/Last Update: 2017-09-12