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小脑动脉远端动脉瘤的瘤内Onyx栓塞术

Intra-aneurysmal Onyx embolization for distal aneurysms of the cerebellar arteries.

作者信息

Gao Xu, Liang Guobiao, Li Zhiqing, Wang Xiaogang, Wei Xuezhong, Zhang Haifeng, Feng Sizhe, Lin Jun

机构信息

Department of Neurosurgery, General Hospital of Shenyang Military Command, Shenyang, China.

出版信息

Neurol Res. 2012 Mar;34(2):211-6. doi: 10.1179/1743132811Y.0000000076. Epub 2012 Feb 3.

Abstract

BACKGROUND

Distal cerebellar artery aneurysms are difficult to treat both surgically and endovascularly. The purpose of this study is to assess the efficacy and safety of intra-aneurysmal Onyx embolization of these lesions with parent artery preservation.

METHODS

Ten consecutive patients harboring 10 distal cerebellar aneurysms were treated with intra-aneurysmal Onyx embolization. Locations of the aneurysms were as follows: superior cerebellar artery in three patients, anterior inferior cerebellar artery in two, and posterior inferior cerebellar artery in five. The technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcome were evaluated.

RESULTS

In every case, endovascular treatment was achieved. Immediate angiography demonstrated that all of 10 aneurysms were completely occluded, with parent artery preservation in nine of them. Procedure-related complication occurred in one patient with transient neurological sequelae. None of the treated aneurysms experienced rebleeding or recanalization during the follow-up time (mean, 12·7 months).

CONCLUSION

We found that the intra-aneurysmal Onyx embolization was helpful in the treatment of distal cerebellar aneurysms in which selective occlusion of the aneurysmal sac with coils or open clipping cannot be achieved.

摘要

背景

小脑远端动脉瘤的手术和血管内治疗都很困难。本研究的目的是评估在保留载瘤动脉的情况下,采用瘤内注射Onyx栓塞治疗这些病变的有效性和安全性。

方法

连续10例患有10个小脑远端动脉瘤的患者接受了瘤内注射Onyx栓塞治疗。动脉瘤的位置如下:3例位于小脑上动脉,2例位于小脑前下动脉,5例位于小脑后下动脉。评估了该手术的技术可行性、与手术相关的并发症、血管造影结果和临床结局。

结果

每例患者均成功进行了血管内治疗。即刻血管造影显示,10个动脉瘤全部完全闭塞,其中9例保留了载瘤动脉。1例患者出现与手术相关的并发症,伴有短暂性神经后遗症。在随访期间(平均12.7个月),所有治疗的动脉瘤均未发生再出血或再通。

结论

我们发现,瘤内注射Onyx栓塞有助于治疗无法通过弹簧圈选择性闭塞瘤囊或开放夹闭治疗的小脑远端动脉瘤。

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