【摘要】：目的:探討支架輔助彈簧圈栓塞治療破裂椎動(dòng)脈夾層動(dòng)脈瘤的安全性及有效性。方法:回顧性分析2011年1月至2016年10月在我院采用支架輔助簧圈栓塞治療的30例破裂椎動(dòng)脈夾層動(dòng)脈瘤患者的臨床表現(xiàn)、DSA表現(xiàn)、即刻栓塞程度、手術(shù)并發(fā)癥及隨訪情況。結(jié)果:30例患者術(shù)中完全栓塞5例,接近完全栓塞6例,部分栓塞19例;術(shù)后1例患者死亡,1例患者術(shù)后出現(xiàn)造影劑腦病,其余無新發(fā)出血或者缺血并發(fā)癥發(fā)生;DSA隨訪25例患者,隨訪時(shí)間6-24月(平均16個(gè)月),隨訪的4例完全栓塞患者表現(xiàn)穩(wěn)定,隨訪的5例接近完全栓塞患者中1例表現(xiàn)為穩(wěn)定,3例表現(xiàn)為改善,1例發(fā)生復(fù)發(fā),隨訪的16例部分栓塞患者,6例表現(xiàn)為改善,7例穩(wěn)定,3例復(fù)發(fā);4例復(fù)發(fā)患者中,2例再次治療,2例未治療。29例患者臨床隨訪2-62個(gè)月(平均26個(gè)月),27例患者臨床結(jié)果和mRS評(píng)分恢復(fù)良好,造影劑腦病患者遺留陣發(fā)性心悸、出汗、右側(cè)側(cè)上肢麻木癥狀,2例患者遺留肢體功能障礙,mRS評(píng)分分別為2,4,2例患者的肌力較入院時(shí)均有不同程度的提高。結(jié)論:支架輔助彈簧圈栓塞治療破裂椎動(dòng)脈夾層動(dòng)脈瘤顯示出較好的安全性及有效性,多支架置入可能會(huì)降低術(shù)后復(fù)發(fā)風(fēng)險(xiǎn),上述結(jié)論均需大樣本研究進(jìn)一步論證。
[Abstract]:Objective: to evaluate the safety and efficacy of stent-assisted coil embolization in the treatment of ruptured vertebral dissecting aneurysms. Methods: the clinical manifestations of 30 patients with ruptured vertebral artery dissecting aneurysms treated with stent assisted Reed coil embolization from January 2011 to October 2016 were retrospectively analyzed. Results complete embolization was found in 5 cases, close to complete embolization in 6 cases, partial embolization in 19 cases in 30 cases, contrast encephalopathy in 1 case died after operation, and 25 cases were followed up with DSA without new bleeding or ischemic complications. The follow-up time was 6-24 months (mean 16 months), 4 cases of complete embolism were stable, and 1 case of 5 cases of close to complete embolism showed stability, 3 cases showed improvement and 1 case recurred. Of the 16 cases of partial embolism followed up, 6 cases showed improvement in 7 cases of stable embolism, 3 cases of recurrence and 4 cases of recurrence. 2 cases were treated again. 29 cases were followed up for 2 to 62 months (mean 26 months), 27 cases were followed up, and 2 cases were followed up for 2 to 62 months (mean 26 months), and 2 cases were followed up for 2 to 62 months (mean, 26 months). The mRS score recovered well, The left limb dysfunction in 2 patients with paroxysmal palpitation, sweating and numbness of the right upper extremity were 2 ~ 4%, respectively. The muscle strength of 2 cases was improved in different degree than that on admission. Conclusion: stent assisted coils embolization for ruptured vertebral dissecting aneurysms is safe and effective, and multi-stent implantation may reduce the risk of postoperative recurrence.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R651.12

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