[1]黄　伟　曾　括　幸　标等.胼周动脉动脉瘤42例治疗分析[J].中国临床神经外科杂志,2021,26(09):662-665.[doi:10.13798/j.issn.1009-153X.2021.09.002]
　HUANG Wei,ZENG Kuo,XING Biao,et al.Microsurgical and endovascular treatment for patients with pericallosal artery aneurysm[J].,2021,26(09):662-665.[doi:10.13798/j.issn.1009-153X.2021.09.002]
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胼周动脉动脉瘤42例治疗分析()
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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09期
页码:
662-665
栏目:
论著
出版日期:
2021-09-25

文章信息/Info

Title:
Microsurgical and endovascular treatment for patients with pericallosal artery aneurysm
文章编号:
1009-153X（2021）09-0662-04
作者:
黄　伟　曾　括　幸　标等
430014 武汉，华中科技大学同济医学院附属武汉中心医院神经外科（黄　伟、曾　括、幸　标、刘　羽、李　俊、陈　文）；430060 武汉，武汉大学人民医院神经外科（曾　括）
Author(s):
HUANG Wei1;  ZENG Kuo2;  XING Biao1;  LIU Yu1;  LI Jun1;  CHEN Wen1. 1.
Department of Neurosurgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China; 2. Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
关键词:
颅内动脉瘤; 胼周动脉动脉瘤; 显微夹闭术; 血管内栓塞; 疗效
Keywords:
Intracranial aneurysm;  Pericallosal artery aneurysm;  Microsurgical clipping;  Endovascula embolization;  Clinical
分类号:
R 743.9; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2021.09.002
文献标志码:
A
摘要:
目的 探讨胼周动脉动脉瘤（PAA）治疗方法及临床疗效。方法 回顾性分析2012年6月至2020年3月收治的42例PAA的临床资料。25例采用夹闭术治疗，17例行血管内栓塞治疗。结果 所有动脉瘤均成功完成夹闭或栓塞，夹闭术后并发症发生率为（48.0%，12/25），栓塞术后并发症发生率（17.6%，3/17）。42例术后临床随访3~12个月，中位数6个月；夹闭术治疗25例末次随访改良Rankin量表（mRS）评分0~2分17例，3~6分8例；预后良好率为68.0%（17/25）；栓塞治疗的17例末次随访mRS评分0~2分14例，3~6分3例；预后良好率为82.4%（14/17）。42例术后影像随访4~21个月，中位数9个月；夹闭术后复发率为12.0%（3/25），栓塞术后复发率为5.9%（1/17）。结论 夹闭术与血管内栓塞是治疗破裂PAA的有效方法，临床上需结合病人具体情况选择个体化的治疗方式以提高治疗效果。
Abstract:
Objective To explore the outcomes of microsurgical and endovascular treatment for the patients with pericallosal artery aneurysm (PAA). Methods A retrospective analysis was performed on the clinical data of 42 patients with ruptured PAA who were admitted to the Central Hospital of Wuhan from June 2012 to March 2020. Of 42 patients, 25 received microsurgical clipping (clipping group) and 17 endovascular embolization (embolization group). Results All the procedures were successfully completed in these 42 patients with PAA. The postoperative complication rates were 48.0% (12/25) and 18.6% (3/17) in clipping and embolization groups, respectively. The clinical follow-up (range, 3~12 months; median, 6 months) outcomes showed good prognosis rates (mRS≤2) of 68.0% (17/25) and 82.4% (14/17) in clipping and embolization groups, respectively. The radiologic follow-up (range, 4~21 months; median, 9 months) outcomes showed reccurrence rates of 12.0% (3/25) and 5.9% (1/17) in clipping and embolization groups, respectively. Conclusions Both surgical clipping and endovascular embolization are effective treatment methods for the patients with PAA. Clinically, it is necessary to choose individualized treatment method based on the specific conditions of the patients in order to improve the treatment efficacy.

参考文献/References:

[1] Aguiar P, Estevao IA, Pacheco CC, et al. Distal anteriorcerebral artery (pericallosal artery) aneurysms: report of 19 cases and literature review [J]. Turk Neurosurg, 2017, 27(5):725-731.
[2] Orz Y. Surgical strategies and outcomes for distal anterior cerebral arteries aneurysms [J]. Asian J Neurosurg, 2011, 6:13-17.
[3] Molyneux AJ, Birks J, Clarke A, et al. The durability ofendovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT) [J]. Lancet, 2015, 385(9969): 691-697.
[4] 钱伟强，任宇涛，甘　奇，等. 大脑前动脉远段囊性动脉瘤的显微外科手术治疗[J]. 中华神经外科杂志，2018，34（10）：1008-1011.
[5] Park J. Pterional or subfrontal access for proximal vascular control in anterior interhemispheric approach for ruptured pericallosal artery aneurysms at risk of premature rupture[J]. J Korean Neurosurg Soc, 2017, 60(2): 250-256.
[6] 黄　巍，王文浩，罗　飞，等. 胼周动脉瘤开颅夹闭术中磁共振神经导航的应[J]. 中国脑血管病杂志，2018，15（6）：281-286.
[7] Yamazaki T, Sonobe M, Kato N, et al. Endovascular coiling as the first treatment strategy for ruptured pericallosal artery aneurysms: results, complications，and follow up [J]. Neurol Med Chir, 2013, 53(6): 409-417.
[8] De Macedo Rodrigues K, Kühn AL, Tamura T, et al. Pipe-line embolization device for pericallosal artery aneurysms: a retrospective single center safety and efficacy study [J]. Oper Neurosurg, 2018, 14(4): 351-358.

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更新日期/Last Update: 1900-01-01