Peluso Jo P P, van Rooij Willem Jan, Sluzewski Menno, Beute Guus N
Department of Radiology, St. Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, Tilburg, The Netherlands.
Neuroradiology. 2007 Sep;49(9):747-51. doi: 10.1007/s00234-007-0251-z. Epub 2007 Jul 4.
The aim of this retrospective study was to determine the incidence, clinical presentation and midterm clinical and imaging outcome of endovascular treatment of 34 superior cerebellar artery (SCA) aneurysms in 33 patients.
Between January 1995 and January 2007, 2,112 aneurysms were treated in our institution, and 36 aneurysms in 35 patients were located on the SCA (incidence 1.7%). Two of three distal SCA aneurysms were excluded. All the remaining 34 SCA aneurysms, of which 22 (65%) were ruptured and 12 (35%) were unruptured, in 33 patients were treated by endovascular techniques. There were 6 men and 27 women ranging from 29-72 years. In 14 patients (42%) multiple aneurysms were present.
Initial angiographic occlusion was (near) complete in 32 aneurysms (94%) and incomplete in 2 aneurysms (6%). Complications leading to permanent morbidity or death occurred in two patients (6.1%, 95% CI 0.6 to 20.60%). Outcome at 6 months follow-up in 31 surviving patients was GOS5 in 26 (84%), GOS4 in 4 (13%) and GOS3 in 1 patient (3%). There were no episodes of (re)bleeding during 118 patient-years of follow-up. The 6-month angiographic follow up in 28 SCA aneurysms and extended angiographic follow-up in 19 showed stable occlusion in 27 aneurysms. No additional treatments were performed.
SCA aneurysms are rare with an incidence of 1.7% of treated aneurysms at our institution. They are frequently associated with other aneurysms. Endovascular treatment is effective and safe in excluding the aneurysms from the circulation.
本回顾性研究旨在确定33例患者中34个小脑上动脉(SCA)动脉瘤的血管内治疗的发生率、临床表现以及中期临床和影像学结果。
1995年1月至2007年1月期间,我院共治疗了2112个动脉瘤,35例患者中有36个动脉瘤位于SCA(发生率为1.7%)。3个远端SCA动脉瘤中的2个被排除。其余33例患者中的34个SCA动脉瘤,其中22个(65%)破裂,12个(35%)未破裂,均采用血管内技术治疗。患者年龄在29至72岁之间,男性6例,女性27例。14例患者(42%)存在多发动脉瘤。
32个动脉瘤(94%)初始血管造影闭塞(接近)完全,2个动脉瘤(6%)不完全闭塞。2例患者(6.1%,95%可信区间0.6至20.60%)出现导致永久性残疾或死亡的并发症。31例存活患者6个月随访时,26例(84%)格拉斯哥预后评分(GOS)为5分,4例(13%)为4分,1例患者(3%)为3分。在118患者年的随访期间无(再)出血事件发生。28个SCA动脉瘤的6个月血管造影随访以及19个动脉瘤的延长血管造影随访显示,27个动脉瘤闭塞稳定。未进行额外治疗。
SCA动脉瘤罕见,在我院治疗的动脉瘤中发生率为1.7%。它们常与其他动脉瘤相关。血管内治疗在将动脉瘤排除于血液循环中方面有效且安全。