【摘要】 目的探讨支架辅助弹簧圈栓塞颈内动脉眼动脉段未破裂动脉瘤的疗效。方法回顾性分析2014年1月至12月支架辅助栓塞治疗的139例颈内动脉眼动脉段未破裂动脉瘤患者的临床资料,采用DSA进行影像学随访,随访时间3~24个月,采用改良Rankin量表(mRS)评价患者预后,随访6~24个月。结果 139例患者有眼动脉段动脉瘤149个,动脉瘤径平均为(6.4±0.5)mm。采用Enterprise支架辅助栓塞101个,Solitaire支架32个,Lvis支架4个,Tubridge支架12个。术后即刻影像学栓塞结果按Raymond分级,Ⅰ级102个(68.5%),Ⅱ级43个(28.9%),Ⅲ级4个(2.7%)。手术相关并发症6例(4.3%),缺血事件4例,其中术后出现肌力Ⅰ级1例,Ⅲ级2例,术后突然出现短暂性患侧失明1例;占位效应导致视力下降1例,动脉瘤破裂出血1例。6例均经对症治疗3个月后好转。129例(92.8%)患者获得影像学随访,共随访135个(90.6%)动脉瘤,其中稳定115个(85.2%),改善11个(8.1%),复发9个(6.7%)。临床随访132例,mRS 0~2分130例(98.5%),mRS 3~6分2例(1.5%)。结论支架辅助弹簧圈栓塞颈内动脉眼动脉段未破裂动脉瘤手术安全可行,但栓塞效果仍需长期影像学随访。更多还原

【Abstract】 Objective To explore the clinical characteristics and clinical effect of endovascular treatment of unruptured ophthalmic segment aneurysms of internal carotid. Methods We consecutively enrolled 139 cases with unruptured ophthalmic segment aneurysms of internal carotid from January 2014 to December 2014. Whose underwent endovascular treatment,after about six months with DSA and modified Rankin scale scores were conducted to evaluate the endovascular treatment results. Results For 139 cases of unruptured ophthalmic segment aneurysms of internal carotid,a total of 149 ophthalmic segment aneurysms were detected in 139 patients. Enterprise stent-asissted coiling was for 101 cases,Solitaire stent-asissted coiling was for 3 2 cases,Lvis stent-asissted coiling was for 4 cases,Tubridge stent-asissted coiling was for1 2 cases. Instant imaging results by Raymond scale( class Ⅰ to class Ⅲ) : class Ⅰ in 1 0 2 cases( 68. 5%),class Ⅱ in 43 cases( 28. 9%),class Ⅲ in 4 cases( 2. 7%). Surgery-related complications were occurred 6 cases( 4. 3%),ischemic events were occurred in 4 cases,including postoperative muscle one in1 case,three in 2 cases,and transient sudden blindness in 1 case; mass effect leading to vision loss in 1 case;aneurysm rupture in 1 case. Six cases were recovered after 3 months of antisypotomatic treatment. A total of135 ophthalmic segment aneurysms( 90. 6%) were followed up in 129 patients( 92. 8%) with imaging,including stable in 115 cases( 85. 2%),improved in 11 cases( 8. 1%),recurrence in 9 cases( 6. 7%). Clincal follow-up was carried out in 1 3 2 cases,mRS 0- 2 was in 1 3 0 cases( 9 8. 5 %),mRS 3- 6 was in2 cases( 1. 5 %). Conclusions Endovascular embolization of unruptured ophthalmic segment aneurysms of internal carotid is safe,it still further studied with long-term follow-up.更多还原