【摘要】 目的探讨小脑后下动脉(PICA)动脉瘤的血管内治疗与手术治疗效果。方法回顾性分析21例PICA动脉瘤患者的临床资料,其中近侧段11例行单纯弹簧圈栓塞1例,支架辅助弹簧圈栓塞7例,开颅夹闭术1例,行枕动脉-PICA血管吻合术1例,保守治疗1例;过渡段5例,行单纯弹簧圈栓塞2例,开颅夹闭术2例,开颅动脉瘤包裹术1例;远侧段5例,行弹簧圈闭塞载瘤动脉1例,NBCA闭塞载瘤动脉1例,Gluba胶闭塞载瘤动脉1例,开颅切除动脉瘤2例。结果术后1周内死亡5例,其余病例随访6~36个月,其中近侧段行单纯弹簧圈栓塞的1例复发,再次行支架辅助弹簧圈栓塞,再随访24个月未见复发;远侧段开颅切除动脉瘤的1例术后出现共济失调,近侧段保守治疗的1例未见动脉瘤增大,其余13例未见复发及明显并发症。结论确保PICA延髓支通畅是治疗PICA动脉瘤的首要前提,PICA动脉瘤的形态、位置、PICA是否为优势血管是动脉瘤治疗方法选择的主要依据,而血管内治疗与手术相辅相成是治疗PICA动脉瘤的有效途径。更多还原

【Abstract】 Objective To explore the methods to treat posterior inferior cerebellar artery(PICA) aneurysms and their effects.MethodsThe clinical data of 21 patients with PICA aneurysms, of whom, 7 were treated by surgery, 13 by the endovascular embolizationand 1 by conservative treatment from January, 2008 to December, 2013, were analyzed retrospectively.ResultsFive patients receivingthe endovascular treatment died within 7 days after the embolization. Sixteen patients were followed up from 6 to 36 months. One patientreceiving coils embolization was treated by stent-assisted coils embolization because the aneurysm recurred 1 year after the coilsembolization. One patient undergoing the surgery still had ataxia during the following up. The aneurysm was unchanged 2 years after theconservative treatment in 1 patient. There were no recurrence of the aneurysms and complications in the other 13 patients during thefollowing up.ConclusionsThe patency of the medullar branch of PICA is a prerequisite for treatment of PICA aneurysms. The method totreat PICA aneurysms should be selected according to the aneurysms and whether PICA is a superior blood vessel or not. The effects ofthe endovascular embolization and surgery on PICA aneurysms are good if the method to treat them is proper for PICA aneurysms.更多还原