Zang Y Z, Wang Z G, Wang C W, Zhang Y, Ding X, Wang X F
The Second Hospital of Shandong University, Jinan 250033, China.
Zhonghua Yi Xue Za Zhi. 2017 Jun 6;97(21):1655-1658. doi: 10.3760/cma.j.issn.0376-2491.2017.21.013.
To evaluate the incidence and risk factors of recurrence after endovascular treatment of vertebrobasilar dissecting aneurysms (VBDAs). Retrospective analysis was used for the clinical information of 40 cases of vertebrobasilar dissecting aneurysms treated with endovascular methods in our department between January 2007 and December 2015.According to whether recurrence occurred, the patients were divided into recurrence group (10 patients) and non-recurrence group (30 patients). The data of the patients' age, sex, hypertension history, smoking history, aneurismal size, presenting symptoms, degree of embolization, GCS scores, aneurismal localization and treatment methods were analyzed to evaluate the risk factors for recurrence after endovascular treatment. There were 40 patients performed long-term angiographic follow-up.The recurrence rate after endovascular treatment was 25.0% (10/40) in the present study, and they all occurred in reconstructive group.Among the patients who underwent stent-assisted coil embolization, recurrence in aneurismal body occurred in 6 patients, and recurrence in aneurismal neck 3 cases. In these cases, 7 recurrences occurred with complete embolization, and 2 recurrences occurred with partial embolization.Recurrence occurred in 1 case that underwent single stent placement.The incidence of recurrence in reconstructive group was higher than that in destructive group (33.3% vs 0.0) with significant difference. The recurrence rate was high in VBDAs treated with endovascular methods.The only independent risk factor for recurrence was reconstructive methods and that suggests the necessity of long-term angiographic follow-up.
评估椎基底动脉夹层动脉瘤(VBDAs)血管内治疗后复发的发生率及危险因素。对2007年1月至2015年12月在我科采用血管内方法治疗的40例椎基底动脉夹层动脉瘤患者的临床资料进行回顾性分析。根据是否复发,将患者分为复发组(10例)和非复发组(30例)。分析患者的年龄、性别、高血压病史、吸烟史、动脉瘤大小、临床表现、栓塞程度、格拉斯哥昏迷量表(GCS)评分、动脉瘤位置及治疗方法等数据,以评估血管内治疗后复发的危险因素。40例患者均进行了长期血管造影随访。本研究中血管内治疗后的复发率为25.0%(10/40),且均发生在重建组。在接受支架辅助弹簧圈栓塞的患者中,瘤体复发6例,瘤颈复发3例。其中,7例复发为完全栓塞,2例复发为部分栓塞。1例单纯放置支架的患者出现复发。重建组的复发率高于毁损组(33.3% vs 0.0),差异有统计学意义。血管内治疗的VBDAs复发率较高。复发的唯一独立危险因素是重建方法,这表明长期血管造影随访的必要性。