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目的:探讨出血性椎动脉夹层动脉瘤的发病机制,评价血管内治疗出血性椎动脉夹层动脉瘤的技术方法及临床疗效方法:应用血管内治疗技术对10例出血性椎动脉夹层动脉瘤的患者进行诊断、治疗,回顾性分析临床资料、血管内治疗经过以及临床疗效。结果:10例患者中有1例单纯球囊闭塞载瘤动脉,7例直接闭塞动脉瘤和载瘤动脉,2例行支架辅助弹簧圈栓塞。术后10例患者接受随访.随访时间为3个月至2年,平均8个月。随访期间8例患者临床症状减轻或消失,没有再出血,1例患者术后出现明显的脊髓动脉缺血症状,在经应用抗凝及扩管治疗后症状改善,1例患者因原出血后呼吸循环衰竭死亡,10例患者中1例死亡。结论:血管内治疗出血性椎动脉夹层动脉瘤最有效的方法,可将载瘤动脉连同动脉瘤完全闭塞,如果动脉瘤位于优势椎动脉,或对侧椎动脉发育不良甚至闭塞,或动脉瘤瘤体发出优势小脑后下动脉,应该使用支架血管成形辅助弹簧圈填塞动脉瘤。
Objective: To investigate the pathogenesis of hemorrhagic vertebral artery dissection aneurysm, evaluate the method of endovascular treatment of hemorrhagic vertebral artery dissection aneurysms and clinical efficacy of methods: application of endovascular treatment of hemorrhagic vertebral artery in 10 cases of aneurysm patients Diagnosis, treatment, retrospective analysis of clinical data, endovascular treatment and clinical efficacy. Results: Of the 10 patients, 1 balloon occluded the parent artery, 7 received direct occlusion aneurysm and the parent artery, and 2 received stent-assisted coil embolization. Ten patients were followed up for 3 months to 2 years with an average of 8 months. During the follow-up period, the clinical symptoms disappeared or disappeared in 8 patients, and there was no further bleeding. One patient showed obvious symptom of spinal cord ischemia after operation, and the symptoms improved after anticoagulation and tube expansion. One patient suffered from post-hemorrhage respiratory cycle Failure died, 10 patients died in 1 case. Conclusion: Endovascular treatment of hemorrhagic vertebral artery dissection aneurysm the most effective way, the parent artery can be completely occluded aneurysm, if the aneurysm is located in the dominant vertebral artery, or contralateral vertebral artery dysplasia or occlusion, or aneurysm The body gives rise to an inferior posterior inferior cerebellar artery, which should be filled with an angioplasty coil.