Marlin Evan S, Ikeda Daniel S, Shaw Andrew, Powers Ciarán J, Sauvageau Eric
Department of Neurosurgery, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, N-1004 Doan Hall, Columbus, OH 43210, USA.
Department of Neurosurgery, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, N-1004 Doan Hall, Columbus, OH 43210, USA.
Neurosurg Clin N Am. 2014 Jul;25(3):485-95. doi: 10.1016/j.nec.2014.04.007.
Basilar artery aneurysms account for a small percentage of intracranial aneurysms; however, they are a diverse group of lesions necessitating different treatment techniques for those that are ruptured and unruptured. Basilar apex aneurysms are the most common type and are frequently wide-necked, necessitating stent-assisted coiling or balloon remodeling. Other techniques have evolved to forego stenting in acutely ruptured wide-necked aneurysms. The prevention of delayed thromboembolic complications with dual antiplatelet therapy in patients with stents is critical. After treatment, basilar aneurysms require close follow-up to ensure complete occlusion. Basilar apex aneurysms often require delayed re-treatment, especially when previously ruptured.
基底动脉动脉瘤在颅内动脉瘤中占比小;然而,它们是一组多样的病变,对于破裂和未破裂的动脉瘤需要采用不同的治疗技术。基底动脉尖部动脉瘤是最常见的类型,且常常具有宽颈,需要支架辅助弹簧圈栓塞或球囊重塑。其他技术已发展到在急性破裂的宽颈动脉瘤中无需使用支架。对于置入支架的患者,采用双重抗血小板治疗预防延迟性血栓栓塞并发症至关重要。治疗后,基底动脉动脉瘤需要密切随访以确保完全闭塞。基底动脉尖部动脉瘤常常需要延迟再次治疗,尤其是既往有过破裂的情况。