CAJ | 학술논문

目的探讨小脑后下动脉(PICA)瘤栓塞治疗的方法及效果.方法回顾性分析21例PICA瘤经血管内栓塞治疗的临床资料,根据DSA资料估计动脉瘤的解削分段.采取单纯弹簧圈栓塞8例、单纯液体胶栓塞5例、弹簧圈联合液体胶栓塞2例、支架辅助弹簧圈栓塞2例、球囊辅助弹簧圈PICA闭塞4例,用格拉斯哥预后(GOS)评分评估疗效.结果单纯弹簧圈致密栓塞5例,90%以上栓塞2例,85%栓寒1例;单纯液体胶栓塞的5例及弹簧圈联合液体胶栓塞的2例均达到致密栓塞;支架辅助弹簧圈栓塞的2例90%以上栓塞;球囊辅助弹簧圈完全闭塞载瘤动脉3例,90%以上栓塞1例.术后脑干穿支动脉闭塞导致死亡1例,术后1周新发神经功能障碍1例,其余未见再出血及小脑损害症状.术后随访6～60个月,平均(22±8)个月.COS评分Ⅰ级1例,Ⅱ级1例,Ⅲ级2例,Ⅳ级5例,Ⅴ级12例.结论根据PICA瘤的解剖分段选择不同的栓塞方法,可取得良好的治疗效果.
목적 탐토소뇌후하동맥(PICA)류전새치료적방법급효과.방법 회고성분석21례PICA류경혈관내전새치료적림상자료,근거DSA자료고계동맥류적해삭분단.채취단순탄황권전새8례、단순액체효전새5례、탄황권연합액체효전새2례、지가보조탄황권전새2례、구낭보조탄황권PICA폐새4례,용격랍사가예후(GOS)평분평고료효.결과 단순탄황권치밀전새5례,90%이상전새2례,85%전한1례;단순액체효전새적5례급탄황권연합액체효전새적2례균체도치밀전새;지가보조탄황권전새적2례90%이상전새;구낭보조탄황권완전폐새재류동맥3례,90%이상전새1례.술후뇌간천지동맥폐새도치사망1례,술후1주신발신경공능장애1례,기여미견재출혈급소뇌손해증상.술후수방6～60개월,평균(22±8)개월.COS평분Ⅰ급1례,Ⅱ급1례,Ⅲ급2례,Ⅳ급5례,Ⅴ급12례.결론 근거PICA류적해부분단선택불동적전새방법,가취득량호적치료효과.
Objective To study the methods and results of endovascular treatment of posterior inferior cerebellar artery (PICA) aneurysms. Methods Twenty-one patients with PICA aneurysms were treated with endovascular treatment. The locations of aneurysm on PICA were evaluated through the DSA. Eight patients received single coil embolization, 5 received liquid Glue embolization, 2 received coil embolization combined with liquid Glue, 2 received coil embolization assisted with stents, and 4 underwent ocelasion of the parent PICA. Outcome was evaluated with the Glasgow outcome scale (COS). Results There were complete (100%) occlusion in 5 patients, near complete (>90% ) occlusion in 2, and incomplete (85%) occlusion in 1 in single coil embolization. Seven patients with Glue embolization (n = 5 ) or combination with coils ( n = 2 ) exhibited complete ( 100% ) occlusion. There were near complete ( >90% ) occlusion in 2 cases with coil assisted with stents. Complete occlusion of the parent PICA was achieved in 3 patients, and near complete occlusion of PICA in one case. One patient suffered from new neurological deficits, and one patient treated with coils and stents died. None of the patients suffered from re-bleeding. These patients received follow-up during a mean period of (22±8) months. Overall long-term outcome was good ( GOS score 4 or 5 ) in 17 patients, poor ( COS score 2 or 3) in 3, and fatal ( GOS score 1 ) in one case. Conclusions According to the location of aneurysms on PICA, aneurysms can be effectively and safely treated with endovaecular embolization.