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目的初步探讨对无法通过单纯栓塞治疗的大脑后动脉(PCA)复杂动脉瘤,采用血管内支架成形术治疗的安全性及疗效。方法回顾性分析第二军医大学附属长海医院神经外科采用支架结合弹簧圈栓塞治疗的PCA复杂动脉瘤4例患者的临床资料。结果 4例患者共4个PCA动脉瘤。3个位于P1～P2段,1个位于P2段;其中1个夹层动脉瘤,3个宽颈动脉瘤;2个破裂动脉瘤,2个未破裂动脉瘤。所有支架均成功置入,共用支架4枚。2个动脉瘤被大部分栓塞,2个被致密栓塞,未发生手术相关并发症。4例术后3个月随访造影,显示动脉瘤均不显影,载瘤动脉通畅,未见支架内狭窄。临床随访3～28个月,4例患者均恢复良好,无症状复发,亦未发生再出血及缺血并发症。结论支架治疗PCA复杂动脉瘤相对安全,短期疗效满意,是可保留载瘤动脉的有效治疗手段。
Objective To investigate the safety and efficacy of endovascular stenting for complex aneurysms of the posterior cerebral artery (PCA) that can not be treated with simple embolization. Methods The clinical data of 4 patients with PCA complex aneurysms treated with stent-coil spring embolization in Department of Neurosurgery, Changhai Hospital, Second Military Medical University were retrospectively analyzed. Results 4 patients had 4 PCA aneurysms. Three were in segment P1-P2 and one was in segment P2; one was dissected aneurysm, three wide-necked aneurysms, two ruptured aneurysms and two unruptured aneurysms. All stents were successfully placed, sharing four stent. Two aneurysms were mostly embolized and two were densely embolized without complications associated with surgery. 4 cases were followed up for 3 months after surgery, showing no aneurysm development, parent artery unobstructed, no stent stenosis. Clinical follow-up of 3 to 28 months, 4 patients recovered well, asymptomatic recurrence, no recurrence of bleeding and ischemic complications. Conclusion Stent treatment of PCA complex aneurysms is relatively safe, short-term effect is satisfactory, is an effective treatment to retain the parent artery.