CAJ | 학술논문

目的探讨颈内动脉床突段微小动脉瘤的治疗方法.方法回顾性分析经临床和影像学方法确诊的18例颈内动脉床突段微小动脉瘤患者资料,其中颈内动脉-眼动脉瘤患者4例,3例行血管内治疗,1例行开颅夹闭;颈内动脉后交通动脉瘤患者10例,3例行血管内治疗,7例行开颅夹闭;颈内动脉脉络膜前动脉瘤患者3例,1例行血管内治疗,2例行开颅夹闭;1例颈内动脉分叉部动脉瘤患者行开颅夹闭.结果 1例颈内动脉-眼动脉瘤患者行弹簧圈栓塞治疗后破裂出血,死亡;1例行支架辅助弹簧圈栓塞治疗颈内动脉后交通动脉瘤患者术中破裂,疏松填塞,术后再次破裂出血,死亡;1例行单纯弹簧圈栓塞治疗颈内动脉后交通动脉瘤患者术中弹簧圈逸出,后行开颅夹闭,恢复好;其余病例预后均良好.结论颈内动脉床突段微小动脉瘤中眼动脉瘤以支架辅助弹簧圈疏松栓塞治疗为宜,开颅夹闭是治疗颈内动脉床突上段微小动脉瘤的首选.
목적 탐토경내동맥상돌단미소동맥류적치료방법.방법 회고성분석경림상화영상학방법학진적18례경내동맥상돌단미소동맥류환자자료,기중경내동맥-안동맥류환자4례,3례행혈관내치료,1례행개로협폐;경내동맥후교통동맥류환자10례,3례행혈관내치료,7례행개로협폐;경내동맥맥락막전동맥류환자3례,1례행혈관내치료,2례행개로협폐;1례경내동맥분차부동맥류환자행개로협폐.결과 1례경내동맥-안동맥류환자행탄황권전새치료후파렬출혈,사망;1례행지가보조탄황권전새치료경내동맥후교통동맥류환자술중파렬,소송전새,술후재차파렬출혈,사망;1례행단순탄황권전새치료경내동맥후교통동맥류환자술중탄황권일출,후행개로협폐,회복호;기여병례예후균량호.결론 경내동맥상돌단미소동맥류중안동맥류이지가보조탄황권소송전새치료위의,개로협폐시치료경내동맥상돌상단미소동맥류적수선.
Objective To investigate the therapies choice of paraclinoid carotid micro-aneurysm.Methods Eighteen patients suffered from paraclinoid carotid microaneurysm,definitely diagnosed by clinical measures and images,were chosen in our study; their clinical data were retrospective analyzed; among them,4 cases suffered from carotid ophthalmic aneurysms,including 3 accepted endovascular treatment and 1 microsurgical clipping; 10 cases suffered from internal carotid artery posterior communicating artery aneurysm,and 3 of them got endovascular treatment and 1 microsurgical clipping; 3 cases had anterior choroidal artery aneurysm of internal carotid artery,including 1 received endovascular treatment and 2 microsurgical clipping; and one was diagnosed as having internal carotid artery bifurcation aneurysms and clipping was performed.Results One patient suffered from carotid ophthalmic aneurysm died from re-rupture after endovascular treatment.One patient suffered from internal carotid artery posterior communicating artery aneurysm died from re-rupture after stent assisted coil embolization.One suffered from internal carotid artery posterior communicating artery aneurysm got good recovery (a spring ring escaped when taking coil embolization of aneurysm,and microsurgical clipping was then performed).Others got well.Conclusion Micro-aneurysms located in supraclinoid intemal carotid arteries and ophthalmic artery can be performed stent assisted loose coil embolization,and others can be preferred craniotomy operation to clip the neck of aneurysms.