Department of Neuroradiology, Centre Hospitalier de l' Universite de Montreal, Montreal, Canada.
AJNR Am J Neuroradiol. 2011 Jan;32(1):174-8. doi: 10.3174/ajnr.A2222. Epub 2010 Sep 2.
The goal of this study was to evaluate the feasibility and efficacy of A1 occlusion at the level of wide necked A1 aneurysms, where there are bilateral patent A1 segments and a patent AcomA. Between 2000 and 2010, 9 patients with wide necked A1 aneurysms were treated by coiling of the aneurysm along with parent vessel occlusion. All aneurysms had a wide neck (≥ 4 mm). None were treated in the acute phase of a subarachnoid hemorrhage. Three small infarcts were noted on routine post-treatment head CT, 1 of which was symptomatic (transient hemiparesthesia). On control angiogram at 6 months or more, 3 A1 recanalizations were found, 2 of which had a stable small neck recurrence. None of the aneurysms ruptured on follow-up. In this series, parent artery occlusion was effective in treating wide-necked aneurysms arising from the A1 segment in patients with adequate collateral supply.
本研究旨在评估 A1 闭塞术治疗宽颈 A1 动脉瘤的可行性和疗效，这些动脉瘤位于双侧 A1 段通畅且 AcomA 通畅的部位。2000 年至 2010 年间，对 9 例宽颈 A1 动脉瘤患者进行了血管内弹簧圈栓塞治疗，同时闭塞载瘤动脉。所有动脉瘤均存在宽颈（≥4mm）。均未在蛛网膜下腔出血的急性期进行治疗。9 例患者在常规治疗后头部 CT 上发现 3 例小梗死灶，其中 1 例有症状（短暂性偏瘫）。6 个月或更长时间后的血管造影复查显示 3 例 A1 再通，其中 2 例出现稳定的小颈再通。随访期间无一例动脉瘤破裂。在本系列中，对于有足够侧支循环供应的患者，载瘤动脉闭塞术治疗 A1 段宽颈动脉瘤是有效的。
