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保留载瘤动脉的血管内治疗小脑前下动脉远端夹层动脉瘤后再破裂:采用 Guglielmi 可脱性弹簧圈闭塞载瘤动脉进行再次治疗

Rerupture following endovascular treatment for dissecting aneurysm of distal anterior inferior cerebellar artery with parent artery preservation: retreatment by parent artery occlusion with Guglielmi detachable coils.

作者信息

Choi C H, Cho W H, Choi B K, Lee S W

机构信息

Department of Neurosurgery, School of Medicine, Pusan National University, Busan, Republic of Korea.

出版信息

Acta Neurochir (Wien). 2006 Mar;148(3):363-6; discussion 366. doi: 10.1007/s00701-005-0702-4. Epub 2005 Dec 19.

Abstract

Distal anterior inferior cerebellar artery (AICA) aneurysms are rare and most cases have been treated surgically by clipping, wrapping or trapping. We recently treated this 20-year-old male patient by an endovascular technique. At first, he was treated by intra-aneurysmal embolisation with parent artery preservation. But he presented with rerupture 1 month after embolisation. Follow-up angiography revealed the regrowth of the aneurysm, which was considered as a dissecting aneurysm. We performed occlusion of the AICA just proximal to the aneurysm to prevent fatal rebleeding. He gradually improved and his level of consciousness fully recovered. At 2 year follow up, he had no neurological deficits. We suggest that embolisation of distal AICA aneurysm with parent artery occlusion may be safe and a simple method in the treatment of distal AICA aneurysms.

摘要

小脑前下动脉(AICA)远端动脉瘤较为罕见,多数病例已通过夹闭、包裹或结扎等手术方法进行治疗。我们最近采用血管内技术治疗了这名20岁男性患者。起初,我们对其进行了保留载瘤动脉的动脉瘤内栓塞治疗。但栓塞术后1个月他出现了再破裂。随访血管造影显示动脉瘤复发,考虑为夹层动脉瘤。我们在动脉瘤近端对AICA进行了闭塞,以防止致命性再出血。他逐渐好转,意识水平完全恢复。随访2年时,他没有神经功能缺损。我们认为,闭塞载瘤动脉的AICA远端动脉瘤栓塞术可能是治疗AICA远端动脉瘤的一种安全且简单的方法。

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