Yu J-L, Wang H-L, Xu N, Xu K, Wang B, Luo Q
Department of Neurosurgery, First Hospital of Jilin University, Changchun, Jilin Province, China.
Interv Neuroradiol. 2010 Dec;16(4):369-83. doi: 10.1177/159101991001600403. Epub 2010 Dec 17.
This study reports our experience with the endovascular treatment of basilar artery (BA) trunk and branch aneurysms. Subjects included 16 patients with BA trunk and branch aneurysms who underwent endovascular treatment in our hospital from October 2000 to October 2009, including four patients with associated arteriovenous malformation (AVM), two with associated moyamoya disease, one with multiple aneurysms at adjacent sites, and one with a distant aneurysm. Endovascular coil embolization, together with stent or balloon assistance when necessary, or while occluding the parent artery was performed. Associated diseases were managed intraoperatively or in the second stage, or treated with gamma knife radiotherapy, or followed up. Two patients with unsuccessful embolization died of re-rupture at the fourth month and fifth month follow-up. The remaining 14 patients reported good outcomes and experienced no re-rupture of either the aneurysm or associated disease. Angiographic follow-ups were conducted for the 14 patients for six to 12 months. Digital subtraction angiography (DSA) examination at the last follow-up showed no recurrence of the BA trunk and branch aneurysms. Together, BA trunk and branch aneurysms should be actively managed via endovascular techniques to prevent serious consequences due to aneurysm rupture and bleeding. Favorable outcomes can be obtained by the proper selection of endovascular treatment regimens.
本研究报告了我们对基底动脉(BA)主干及分支动脉瘤进行血管内治疗的经验。研究对象包括2000年10月至2009年10月期间在我院接受血管内治疗的16例BA主干及分支动脉瘤患者,其中4例合并动静脉畸形(AVM),2例合并烟雾病,1例在相邻部位有多发动脉瘤,1例有远处动脉瘤。采用血管内弹簧圈栓塞术,必要时辅以支架或球囊,或同时闭塞载瘤动脉。相关疾病在术中或二期进行处理,或采用伽马刀放疗,或进行随访。2例栓塞失败的患者在随访的第4个月和第5个月因再破裂死亡。其余14例患者预后良好,动脉瘤及相关疾病均未再破裂。对这14例患者进行了6至12个月的血管造影随访。最后一次随访时的数字减影血管造影(DSA)检查显示BA主干及分支动脉瘤无复发。总之,应通过血管内技术积极处理BA主干及分支动脉瘤,以防止动脉瘤破裂出血导致的严重后果。通过合理选择血管内治疗方案可获得良好预后。