A challenging entity of unruptured giant saccular aneurysms of vertebrobasilar artery
A challenging entity of unruptured giant saccular aneurysms of vertebrobasilar artery
复制标题
椎基底动脉未破裂巨大囊状动脉瘤的一个具有挑战性的实体
DOI：
10.1016/j.pjnns.2016.04.001
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发表时间：
2016-01-01
影响因子：
2.9
通讯作者：
Lv, Xianli
中科院分区：
文献类型：
--
作者：
Ge, Huijian;Li, Youxiang;Lv, Xianli
目的：巨大颅内动脉瘤通常会导致临床结果不佳，很少有研究关注它们。本研究旨在回顾性报告接受和不接受血管内治疗的未破裂巨大囊状椎基底动脉瘤的血管造影和临床表现。方法：在单个中心的 400 名未破裂后循环动脉瘤患者中，我们发现了 10 例未破裂巨大（> 25 mm）囊状椎基底动脉瘤。对临床和血管造影表现及其临床结果进行了评估。结果：10 名患者的 10 个巨大动脉瘤中，有 3 个未得到治疗。在 6 个月的随访中，这 3 名患者全部死于动脉瘤破裂。其余7例患者接受血管内手术治疗，5例接受支架辅助弹簧圈栓塞治疗，1例患者接受载瘤动脉闭塞（PAO）治疗，1例患者接受常规弹簧圈栓塞治疗。在这些接受治疗的患者中，只有一名在22个月的随访期间存活。结论：存在占位效应的椎基底动脉巨大囊状动脉瘤患者的临床结果可能极差，可能无法从血管内治疗中获益。 (C) 2016 年波兰神经病学学会。由爱思唯尔公司出版。 z o.o.版权所有。
Purpose: Giant intracranial aneurysms commonly cause poor clinical outcome and few studies focus on them. This study is to retrospectively report the angiographic and clinical presentations in unruptured giant saccular vertebrobasilar aneurysms with and without endovascular treatment.Methods: Out of 400 patients who had unruptured posterior circulation aneurysms in a single center, we found 10 unruptured giant (>25 mm) saccular vertebrobasilar aneurysms. Clinical and angiographic presentations as well as their clinical outcomes were assessed.Results: Of the 10 giant aneurysms in 10 patients, three were left untreated. During 6 months follow-up, all 3 of these patients died from aneurysm rupture. The remaining 7 patients were treated by endovascular procedure, 5 received stent-assisted coiling, 1 was treated by parent artery occlusion (PAO), and 1 was treated by conventional coiling. Of these treated patients, only one survived during a 22 month period of follow-up.Conclusions: Patients with giant saccular aneurysms of vertebrobasilar artery presenting mass effect may have extremely poor clinical outcomes and may not benefit from endovascular treatment. (C) 2016 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved.