Wang Yiheng, Xu Kan, Song Jia, Yu Jinlu
Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China.
Department of Neurology, The First Hospital of Jilin University, Changchun, China.
Front Neurol. 2021 Feb 15;12:625909. doi: 10.3389/fneur.2021.625909. eCollection 2021.
Although aneurysms rarely occur in the basilar artery (BA) trunk, the majority of those that do are dissection aneurysms. Currently, the mainstream therapy for BA trunk aneurysms is endovascular therapy (EVT), which mainly includes single coiling or conventional low-metal-coverage stent-assisted EVT, but the efficacy remains to be evaluated. A retrospective study was performed for the patients who were admitted to our institution for BA trunk aneurysms and underwent EVT. A total of 28 patients were collected in this study. The patients were aged 23-71 years (53.7 ± 11.5 years on average); nine were female (32.1%, 9/28), and 19 were male (67.9%, 19/28). The patients were given single coiling or conventional low-metal-coverage stent-assisted EVT. Among the 28 patients, 10 (35.7%, 10/28) developed complications, 90% (9/10) of which were ischemic and 10% (1/10) were hemorrhagic. Among the 28 patients, 5 (17.9%, 5/28) died. The surviving 23 patients (82.1%, 23/28) recovered well. This study found that for BA trunk aneurysms, single coiling or conventional low-metal-coverage stent-assisted EVT still had some risks. The risks are mainly from brainstem ischemia. Therefore, the perforators of the BA trunk must be carefully evaluated and prevented from receiving damage from the EVT procedure. This study also shows that 82.1% of patients recovered well. Therefore, EVT can result in an acceptable prognosis.
尽管动脉瘤很少发生在基底动脉（BA）主干，但发生的大多数是夹层动脉瘤。目前，BA主干动脉瘤的主流治疗方法是血管内治疗（EVT），主要包括单纯弹簧圈栓塞或传统低金属覆盖率支架辅助EVT，但疗效仍有待评估。对我院收治的BA主干动脉瘤并接受EVT治疗的患者进行了一项回顾性研究。本研究共纳入28例患者。患者年龄23 - 71岁（平均53.7±11.5岁）；女性9例（32.1%，9/28），男性19例（67.9%，19/28）。患者接受单纯弹簧圈栓塞或传统低金属覆盖率支架辅助EVT。28例患者中，10例（35.7%，10/28）发生并发症，其中90%（9/10）为缺血性并发症，10%（1/10）为出血性并发症。28例患者中，5例（17.9%，5/28）死亡。存活的23例患者（82.1%，23/28）恢复良好。本研究发现，对于BA主干动脉瘤，单纯弹簧圈栓塞或传统低金属覆盖率支架辅助EVT仍存在一些风险。风险主要来自脑干缺血。因此，必须仔细评估BA主干的穿支血管，并防止其在EVT手术中受到损伤。本研究还表明，82.1%的患者恢复良好。因此，EVT可带来可接受的预后。
