摘要目的 探讨颈内动脉血泡样动脉瘤的治疗方法及其预后.方法 回顾性分析华中科技大学同济医学院附属同济医院神经外科2014年1月至2016年1月经数字减影血管造影确诊的15例颈内动脉血泡样动脉瘤患者的临床资料.15例患者共16个动脉瘤.2例采用开颅手术,其中行动脉瘤包裹术1例,单纯夹闭术l例;其余13例行支架辅助弹簧圈栓塞.行血管内治疗的患者以改良Rankin量表评分(mRS)评估预后.平均随访11个月(3～22个月).结果 1例行动脉瘤包裹术的患者症状好转,出院后失访.1例行单纯夹闭术的患者术后发生再出血死亡.13例行血管内治疗的患者术后造影显示均达完全栓塞,其中1例术后再出血死亡;1例随访期内瘤颈处复发,再次行支架辅助弹簧圈栓塞治疗.12例患者出院后3个月mRS评分0分5例,1分6例,4分1例.结论 颈内动脉血泡样动脉瘤行支架辅助弹簧圈栓塞治疗的总体疗效满意,是一种安全的治疗方法.

abstractsObjective To study the treatment options and prognosis of blood blister-like aneurysms ot internal carotid artery.Methods Clinical Data of 15 people with 16 blood blister-like aneurysms confirmed by DSA who were admitted to Department of Neurosurgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2014 to January 2016 were retrospectively studied.In this series,craniotomy was performed in 2 cases (including 1 aneurysm wrapping and 1 clipping) and stent-assisted coil embolization was applied in the other 15 cases.The outcomes of patients undergoing endovascular treatment were assessed based on the modified Rankin Scale (mRS) 3 months post discharge.The mean follow-up period was 11 months and ranged from 3 to 22 months.Results The patient receiving aneurysm wrapping achieved symptomatic improvement and was lost to follow-up after discharge.Postoperative rebleeding occurred in the patient undergoing clipping and resulted in death.Complete embolization was observed in all 13 patients who underwent endovascular treatment.Among the 13 cases,1 patient died because of postoperative rebleeding and 1 patient developed recurrence at the neck of aneurysm and received a second operation of stent-assisted coil embolization.The mRS assessment for 12 patients at 3 months post discharge indicated 0 in 5 cases,1 in 6 cases and 4 in 1 case.Conclusion Stent-assisted coil embolization for blood blister-like aneurvsms of the internal carotid artery could lead to overall satisfactory outcomes with good safety.