[1]孙际典,曹杨,王清河,等.血管内治疗床突旁动脉瘤的方法选择及疗效分析[J].临床神经外科杂志,2019,16(1):49-53.[doi:10.3969/j.issn.1672-7770.2019.01.011]
 SUN Ji-dian,CAO Yang,WANG Qing-he,et al.Methods and curative effect of endovascular treatment for paraclinoid aneurysm[J].Journal of Clinical Neurosurgery,2019,16(1):49-53.[doi:10.3969/j.issn.1672-7770.2019.01.011]
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血管内治疗床突旁动脉瘤的方法选择及疗效分析 ()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第1期
页码:
49-53
栏目:
论著
出版日期:
2019-02-18

文章信息/Info

Title:
Methods and curative effect of endovascular treatment for paraclinoid aneurysm
作者:
孙际典曹杨王清河刘震崔啸天姜除寒梁士凯
100015 北京,首都医科大学北京地坛医院神经外科(孙际典,曹杨,王清河);中国医科大学顺义医院神经外科(刘震);重庆医科大学第一临床学院(崔啸天);首都医科大学北京天坛医院神经介入科(姜除寒);北京清华长庚医院神经外科(梁士凯)
Author(s):
SUN Ji-dian CAO Yang WANG Qing-he et al.
Department of Neurosurgery, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
关键词:
床突旁动脉瘤血管内治疗方法选择疗效
Keywords:
paraclinoid aneurysm endovascular methods curative effect
分类号:
R739.41;R651.1
DOI:
10.3969/j.issn.1672-7770.2019.01.011
文献标志码:
A
摘要:
目的探讨床突旁动脉瘤的特点及评估不同的血管内治疗方案的价值。方法回顾性分析北京地坛医院神经外科及北京清华长庚医院自2014年7月—2018年1月住院行血管内治疗的98例颅内床突旁动脉瘤(共104个动脉瘤)患者的临床资料、影像资料及随访结果。结果本组98例患者(共104个颅内动脉瘤)血管内治疗失败2例(2个动脉瘤),余下96例(102个动脉瘤)血管内治疗成功后即时造影示:90个动脉瘤完全栓塞,4个动脉瘤有瘤颈残余,动脉瘤体残余3个。术中9例患者动脉瘤破裂出血,3例患者有支架内血栓,6例患者有弹簧圈脱逸现象。术后2例患者视物模糊,难治性头痛1例,难治性眼球后疼痛1例。术后临床随访所有患者的Rankin 评分为0~5分,2例患者死亡。92例患者(98个动脉瘤)术后获影像学随访,11例动脉瘤复发患者(11个动脉瘤)接受再治疗。结论本研究结果显示对于破裂和未破裂的床突旁动脉瘤,新型血管内栓塞材料存在某些局限性,且安全性及有效性有待进一步证实,传统的血管内治疗方法仍是有效的治疗方案,但是由于高分流率的存在,大部分动脉瘤需要支架辅助技术,术中尽量做到致密栓塞。
Abstract:
Abstract: ObjectiveTo explore the clinic characteristics of paraclinoid aneurysms and evaluate the value of different endovascular treatment for it. MethodsThe clinical data, image data and follow-up results of 98 patients(104 paraclinoid aneurysms) underwent endovascular treatment at Department of Neurosurgery, Beijing Ditan Hospital and Department of Neurosurgery, Beijing Tsinghua ChangGung Hospital from July 2014 to Janurary 2018,were analyzed retrospectively. ResultsOf the 98 patients(104 aneurysms), 2 (2 aneurysms) failed, immediate angiogram after procedure of the other 96(102 aneurysms) showed complete occlusion in 90 aneurysms, residual necks were left in 4 aneurysms, residual aneurysm were left in 3. There were 22 patients experienced periprocedual complications,6 aneurismal perforations during the procedure, 3 instent thromboses, 2 blurred vision, 1 intractable headache and 1 pain behind the eye. Clinical followup showed all the patients’ Rankin scale was 05, 2 patients died. 11 of the 98 aneurysm experienced retreatment. The follow-up was continued. ConclusionsThis study indicates that the new interventional therapy material has some limation in treating ruptured and unruptured paraclinoid aneurysms, and addional evidence is needed to support their efficacy and safety. The conventional endovascular treatment is still a safe and effective therapeutic alternative. But most of the aneurysms need stent assisted coiling because of the high recurrence rate.

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更新日期/Last Update: 2019-02-18