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脉络膜前动脉起始部动脉瘤的血管内治疗及血管造影特征

Endovascular Treatment and Angiographic Characteristics of Aneurysms at the Origin of the Anterior Choroidal Artery.

作者信息

Wang Yiheng, Yu Jinlu

机构信息

Department of Neurosurgery, The First Hospital of Jilin University, Changchun, China.

出版信息

Front Neurol. 2022 Mar 14;13:832604. doi: 10.3389/fneur.2022.832604. eCollection 2022.

Abstract

BACKGROUND

The information available about the variations and anatomy of the anterior choroidal artery (AchA) with aneurysm at the origin of the vessel and the outcomes of endovascular treatment (EVT) for AchA aneurysms is incomplete.

MATERIALS AND METHODS

A retrospective study of 54 consecutive patients who were admitted to our hospital with a diagnosis of AchA aneurysm and treated with EVT was performed. The variations and anatomy of the AchA and the outcomes of EVT for AchA aneurysms were analyzed.

RESULT

The 54 patients were aged 35-82 years (mean age, 56.1 ± 19.7 years) and included 32 females (59.3%, 32/54). Regarding AchA anatomy, 63.5% of AchAs had a typical S-shaped course. The diameter of the AchA origin averaged 0.8 ± 0.3 mm. Of all the AchA aneurysms, 51.9% were ruptured. The diameter of AchA aneurysms averaged 4.1 ± 2.4 mm. Moreover, 40.7% of 54 cases had multiple aneurysms. EVT was assisted with stenting for 25.9% of 54 AchA aneurysms. An immediate Modified Raymond-Roy Classification grade of I was obtained in 96.3% of AchA aneurysm cases. After EVT, the ischemic complication rate was 13%. In total, 83% of patients had good outcomes, with a Glasgow Outcome Scale score of 4-5. Follow-up angiography showed acceptable treatment results in this study.

CONCLUSION

The study showed that the AchA had a complex angiographic anatomy in cases with aneurysms at the origin of the vessel and that the anatomical features can be helpful in EVT. EVT for aneurysms at the origin of the AchA had good outcomes.

摘要

背景

关于脉络膜前动脉(AchA)在血管起源处伴有动脉瘤的变异和解剖结构以及脉络膜前动脉瘤的血管内治疗(EVT)结果的现有信息并不完整。

材料与方法

对我院连续收治的54例诊断为脉络膜前动脉瘤并接受血管内治疗的患者进行回顾性研究。分析脉络膜前动脉的变异和解剖结构以及脉络膜前动脉瘤的血管内治疗结果。

结果

54例患者年龄在35 - 82岁之间(平均年龄56.1±19.7岁),其中女性32例(59.3%,32/54)。关于脉络膜前动脉的解剖结构,63.5%的脉络膜前动脉走行呈典型的S形。脉络膜前动脉起源处的直径平均为0.8±0.3mm。在所有脉络膜前动脉瘤中,51.9%为破裂动脉瘤。脉络膜前动脉瘤的直径平均为4.1±2.4mm。此外,54例中有40.7%的患者存在多发动脉瘤。54例脉络膜前动脉瘤中有25.9%在血管内治疗时辅助使用了支架。96.3%的脉络膜前动脉瘤病例术后即刻改良雷蒙德 - 罗伊分级为I级。血管内治疗后,缺血性并发症发生率为13%。总体而言,83%的患者预后良好,格拉斯哥预后量表评分为4 - 5分。本研究的随访血管造影显示治疗效果可接受。

结论

该研究表明,在脉络膜前动脉起源处伴有动脉瘤的病例中,脉络膜前动脉具有复杂的血管造影解剖结构,且这些解剖特征有助于血管内治疗。脉络膜前动脉起源处动脉瘤的血管内治疗效果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f514/8963998/1e5c7dbb31b4/fneur-13-832604-g0001.jpg

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