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基底动脉瘤的血管内治疗

Endovascular treatment of basilar aneurysms.

作者信息

Marlin Evan S, Ikeda Daniel S, Shaw Andrew, Powers Ciarán J, Sauvageau Eric

机构信息

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.

出版信息

Neurosurg Clin N Am. 2014 Jul;25(3):485-95. doi: 10.1016/j.nec.2014.04.007.

Abstract

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.

摘要

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。

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