【摘要】：目的： 回顧性分析46例基底動(dòng)脈頂端動(dòng)脈瘤的血管內(nèi)栓塞治療結(jié)果，探討基底動(dòng)脈頂端動(dòng)脈瘤血管內(nèi)栓塞治療的安全性和有效性。 方法： 收集吉林大學(xué)第一醫(yī)院神經(jīng)血管病外科自2005年7月至2013年12月期間收住的53例基底動(dòng)脈尖部動(dòng)脈瘤的臨床資料并進(jìn)行分析，其中46例均行血管內(nèi)栓塞治療。 結(jié)果： 46例患者均成功的進(jìn)行了血管內(nèi)栓塞治療，男16例，女30例。年齡25～72歲，平均48.5歲。所有患者均行CTA、MRA或DSA檢查明確診斷為基底動(dòng)脈頂端動(dòng)脈瘤。46例中合并其他血管病18例，其中合并后交通動(dòng)脈瘤8例，合并大腦中動(dòng)脈動(dòng)脈瘤4例，合并煙霧病6例。40例動(dòng)脈瘤破裂者均行頭顱CT檢查，顯示不同程度蛛網(wǎng)膜下腔出血，其中4例合并腦室出血。動(dòng)脈瘤直徑2~11mm，其中5mm16例，5~10mm26例，10mm4例。寬頸動(dòng)脈瘤(瘤頸≥4mm或者瘤頸：瘤體≥1：2)36例。未破裂動(dòng)脈瘤6例，破裂動(dòng)脈瘤40例。臨床表現(xiàn)主要癥狀：頭痛、惡心、嘔吐35例，突發(fā)意識(shí)不清5例，突發(fā)頭暈伴肢體功能障礙4例，無癥狀體檢意外發(fā)現(xiàn)2例，Hunt-HessI～I(xiàn)I級(jí)39例，Hunt-Hess III～V級(jí)5例。1例術(shù)中出現(xiàn)出血，其余均成功栓塞。其中單純彈簧圈栓塞8例、支輔助栓塞38例，動(dòng)脈瘤100％栓塞36例（78．2％)，90％以上栓塞8例(17．3％)，90％以下栓塞2例(4．3％)。并發(fā)基底動(dòng)脈尖綜合癥1例，無死亡。出院時(shí)GOS評(píng)分為5分42例；4分4例。術(shù)后隨訪6個(gè)月到22個(gè)月，平均（16.6±2.8）個(gè)月，39例同栓塞當(dāng)時(shí)相比無變化，5例復(fù)發(fā)，1例隨訪1年后死亡，失訪1例。 結(jié)論： 血管內(nèi)栓塞治療是基底動(dòng)脈尖部動(dòng)脈瘤安全有效的治療方法，并發(fā)癥相對(duì)少，，治療效果良好，患者致殘致死率低，但是同時(shí)存在潛在風(fēng)險(xiǎn)，如出現(xiàn)痙攣、缺血，否則后果嚴(yán)重。
[Abstract]:Objective: to retrospectively analyze the results of endovascular embolization of 46 cases of aneurysms at the top of the basilar artery, and to explore the safety and efficacy of endovascular embolization of the apical aneurysms of the basilar artery. Methods: the clinical data of 53 cases of basilar artery apex aneurysms collected from July 2005 to December 2013 in the Department of Neuroangiopathy in the first Hospital of Jilin University were collected and analyzed. Among them 46 cases were treated with endovascular embolization. Results: 46 patients were successfully treated by endovascular embolization, including 16 males and 30 females. The average age was 48.5 years. All the patients were diagnosed by CTA,MRA or DSA. Among 46 cases, 18 cases were complicated with other angiopathy, including 8 cases with posterior communicating artery aneurysm, 4 cases with middle cerebral artery aneurysm, 4 cases with posterior communicating artery aneurysm, 4 cases with middle cerebral artery aneurysm, 8 cases with posterior communicating artery aneurysm and 4 cases with middle cerebral artery aneurysm. 6 cases were complicated with moyamoya disease. 40 cases of ruptured aneurysm were examined by CT, which showed subarachnoid hemorrhage of different degree, 4 of which were complicated with ventricular hemorrhage. The diameter of aneurysm was 2mm, including 5mm16, 5~10mm26 and 10mm4. 36 patients with wide neck aneurysm (neck 鈮

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