CAJ | 학술논문

目的：探讨支架辅助栓塞技术治疗未破裂的椎动脉夹层动脉瘤的疗效。方法：回顾性分析59例支架辅助栓塞术治疗未破裂的椎动脉夹层动脉瘤患者的临床资料及预后。所有患者按治疗方式分为两组：单一支架结合弹簧圈治疗31例（单一支架组），双支架结合弹簧圈辅助栓塞28例（多重支架组），比较两组患者术后即刻动脉瘤栓塞程度、预后改良Rankin评分（mRS）、动脉瘤复发率。结果：56例患者预后良好（mRS 0～1分），两组预后 mRS 评分比较差异无统计学意义（P ＝0．24），多重支架组动脉瘤即刻栓塞率明显高于单一支架组（75．0％ vs．41．9％， P ＝0．010），且多重支架组动脉瘤复发率低于单一支架组（0％ vs．19．4％，P ＝0．043）。结论：支架辅助栓塞治疗未破裂的椎动脉夹层动脉瘤疗效确切，并发症少，多重支架结合弹簧圈技术可明显提高动脉瘤的栓塞程度，降低动脉瘤的复发率，其疗效还需大宗病例进一步验证。
목적：탐토지가보조전새기술치료미파렬적추동맥협층동맥류적료효。방법：회고성분석59례지가보조전새술치료미파렬적추동맥협층동맥류환자적림상자료급예후。소유환자안치료방식분위량조：단일지가결합탄황권치료31례（단일지가조），쌍지가결합탄황권보조전새28례（다중지가조），비교량조환자술후즉각동맥류전새정도、예후개량Rankin평분（mRS）、동맥류복발솔。결과：56례환자예후량호（mRS 0～1분），량조예후 mRS 평분비교차이무통계학의의（P ＝0．24），다중지가조동맥류즉각전새솔명현고우단일지가조（75．0％ vs．41．9％， P ＝0．010），차다중지가조동맥류복발솔저우단일지가조（0％ vs．19．4％，P ＝0．043）。결론：지가보조전새치료미파렬적추동맥협층동맥류료효학절，병발증소，다중지가결합탄황권기술가명현제고동맥류적전새정도，강저동맥류적복발솔，기료효환수대종병례진일보험증。
Objective To evaluate the efficacy of stent-assisted coiling in the treatment of unruptured vertebral dissecting aneurysm. Methods We retrospectively reviewed 59 consecutive patients with unruptured vertebral dissecting aneurysms that underwent endovascular treatment. 31 patients received single stent-assisted coiling, 28 patients received multiple stent-assisted coiling. Results Clinical outcome was favorable in 56 of the 59 patients, the modified Rankin Scale score had no difference in both groups (P = 0.24). The immediate obliteration grade in multiple-stent group was higher than that in single-stent group (75.0% vs. 41.9%, P=0.010). What′s more, the recurrence rate was lower in multiple-stent group (0% vs. 19.4%, P = 0.043). Conclusions Stent-assisted coiling in the treatment of unruptured vertebral dissecting aneurysm is safe and effective , multilayer disposition of stents with coils will decrease the complications and facilitate the aneurysmal occlusion. Larger , prospective studies are necessary to explore the long-term outcomes of reconstruction therapy.