Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, Paris VI University, 47 Bd de l'Hôpital, 75013, Paris, France.
Neuroradiology. 2011 Dec;53(12):973-82. doi: 10.1007/s00234-010-0800-8. Epub 2010 Dec 9.
The purpose of this study was to present the long-term clinical and angiographic follow-up (FU) in 26 consecutive patients with giant/large aneurysms (G/LAs) of the internal carotid artery (ICA) treated by parent artery occlusion (PAO).
Twenty-two of 26 G/LAs of the ICA were treated by PAO when a balloon test occlusion prior to occlusion of the ICA was tolerated. Clinical and angiographic FU were available in, respectively, 20 and 18 patients with a mean delay of 6.1 years (range 1.5-11).
At long-term FU, clinical symptoms had disappeared in 75% of the patients, partially regressed in 10%, and remained unchanged in 15% of cases. No patient presented worsening of clinical symptoms or intracranial bleeding. Fifteen patients presented a modified Rankin scale score of 0 and five patients a score of 1. On imaging FU, persistent occlusion of the PA was observed in 17/18 cases. One case of aneurysmal recanalization was observed at long-term FU. PAO was well tolerated in all patients. On angiographic FU, no new lesion was detected, except the growing of a pre-existing aneurysm located on the carotid siphon contralateral to the occluded vessel.
Our study demonstrates that occlusion of the parent artery for giant/large ICA aneurysms remains a safe and effective technique with good clinical and angiographic outcome at long-term FU.
本研究旨在介绍 26 例连续的颈内动脉（ICA）巨大/大动脉瘤（G/LAs）患者的长期临床和血管造影随访（FU）结果，这些患者均接受了母动脉闭塞（PAO）治疗。
26 例 ICA 巨大/大动脉瘤中，有 22 例在耐受 ICA 闭塞前的球囊试验闭塞后接受了 PAO 治疗。20 例患者可获得临床 FU，18 例患者可获得血管造影 FU，平均延迟时间为 6.1 年（范围 1.5-11 年）。
在长期 FU 时，75%的患者临床症状消失，10%的患者部分缓解，15%的患者症状无变化。无患者出现临床症状恶化或颅内出血。15 例患者改良 Rankin 量表评分为 0，5 例患者评分为 1。在影像学 FU 时，18 例患者中观察到 PA 持续闭塞。1 例患者在长期 FU 时出现动脉瘤再通。PAO 在所有患者中均耐受良好。在血管造影 FU 时，除闭塞血管对侧颈动脉虹吸处的一个先前存在的动脉瘤生长外，未发现新的病变。
我们的研究表明，对于巨大/大 ICA 动脉瘤，闭塞母动脉仍然是一种安全有效的技术，具有良好的临床和血管造影结果，在长期 FU 时效果良好。
