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目的探讨血管内介入治疗椎-基底巨大动脉瘤的临床疗效和安全性。方法回顾分析2002年1月至2015年1月收治的27例椎-基底巨大动脉瘤患者的临床资料。25例行电解可脱性弹簧圈(GDC)及水解可脱铂金弹簧圈(DCS)血管内栓塞治疗。2例行载瘤动脉闭塞术。结果 27例椎-基底巨大动脉瘤栓塞成功率100%,其中完全栓塞24例,占88.89%,不完全栓塞3例,占11.11%。术后均未发生再出血、栓塞、神经功能障碍、瘫痪、死亡等并发症。术后3个月行数字减影血管造影(DSA)检查,未见瘤体影像,支架位置理想,无狭窄,支架内血流通畅,其中18例瘤体明显缩小。随访2~36个月,术后均未发生出血或再出血。结论血管内介入治疗为椎-基底巨大动脉瘤的治疗提供了安全、有效的治疗方法,能够显著提高治愈率,降低并发症发生率。
Objective To investigate the clinical efficacy and safety of endovascular interventional treatment of vertebrobasilar giant aneurysms. Methods The clinical data of 27 patients with vertebrobasilar giant aneurysm treated from January 2002 to January 2015 were retrospectively analyzed. Twenty - five patients underwent GDC and DCS intravascular embolization. 2 cases of tumor-bearing artery occlusion. Results The successful rate of vertebral-basal giant aneurysm embolization was 100% in all 27 cases, of which 24 cases were completely embolized, accounting for 88.89%. Three cases were incomplete embolization, accounting for 11.11%. No postoperative bleeding, embolism, neurological dysfunction, paralysis, death and other complications. Three months after the operation, digital subtraction angiography (DSA) was performed. There was no tumor image, the position of the stent was ideal, and there was no stenosis. The blood flow in the stent was unobstructed, of which 18 cases were significantly reduced. All cases were followed up for 2 to 36 months without any bleeding or rebleeding. Conclusion Endovascular interventional therapy provides a safe and effective treatment for vertebrobasilar giant aneurysms, which can significantly improve the cure rate and reduce the incidence of complications.