Endovascular reconstruction for ruptured and unruptured vertebral artery fusiform aneurysms
10.3969/j.issn.1672-5921.2018.05.002
- VernacularTitle:椎动脉颅内段破裂与未破裂梭形动脉瘤的血管内重建治疗
- Author:
Peng QI
1
;
Ximeng YANG
;
Lijun WANG
;
Jun LU
;
Junjie WANG
;
Shen HU
;
Kunpeng CHEN
;
Haifeng WANG
;
Daming WANG
Author Information
1. 100730,北京医院神经外科 国家老年医学中心
- Keywords:
Intracranial aneurysm;
Aneurysm,ruptured;
Vertebral artery;
Cerebral revascularization;
Fusiform aneurysm;
Unruptured aneurysm
- From:
Chinese Journal of Cerebrovascular Diseases
2018;15(5):231-235,封3
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and efficacy of endovascular reconstruction for ruptured and unruptured vertebral artery fusiform aneurysms (VAFAs).Methods The clinical,imaging and follow-up data of 26 consecutive patients with VAFA treated with endovascular reconstruction at the Department of Neurosurgery,Beijing Hospital between October 2009 and September 2017 were analyzed retrospectively.Results (1) Twenty-six patients had 26 VAFAs.Their age ranged from 38 to 69 years old.Nine patients had ruptured aneurysms and 17 had unruptured aneurysms.The diameter of the aneurysms ranged from 5 to 12 mm.The success rate of reconstruction technology was 100％.(2)In 9 patients of the rupture group,8 were embolized by stent-assisted coils,1 was treated with stent-assisted coil embolization alone.Five patients were treated with multiple-stent reconstruction and 4 were treated with stent reconstruction alone.Of the 17 patients in the unrupture group,13 were treated with stent-assisted embolization and 4 were treated with stent implantation alone;7 were treated with multiple-stent reconstruction,and 10 were treated with stent reconstruction alone.No perioperative complications occurred.(3) The patients were followed up for 8.0-97.5 months with a median time of 39.5 months.No new cerebral infarction or cerebral hemorrhage occurred.The patients with good prognosis (the modified Rankin scale scale 0-2) was 100％.Twenty-two patients were followed up for 3.5 to 34.0 months with a median time of 10.3 months.Fourteen patients (63.6％) were cured,4 (18.2％) were stable or improved,and 4 (18.2％) had recurrence;Five of 8 patients were cured in the rupture group;9 of 14 were cured in the unrupture group.There were 2 cases of relapse in each of the two groups.Conclusions Endovascular reconstruction for ruptured and unruptured VAFAs is clinically feasible and the safety is higher.The efficacy of mid-term and long-term follow-up is better.The recurrence rate of ruptured VAFAs has an increasing trend,and close follow-up is required after procedure.
