摘要目的 探讨血管内治疗基底动脉夹层动脉瘤(BDA)的安全性和有效性.方法 回顾性分析2009年1月至2014年6月在河南省人民医院脑血管复合手术外科接受血管内治疗的21例BDA患者的临床资料,探讨患者术后短期(≤1年)和长期(＞3年)疗效.结果 21例患者中,7例采用单纯支架置入术,术后即刻造影瘤体均部分显影;14例采用支架联合弹簧圈栓塞术,术后即刻造影瘤体不显影5例,瘤体部分显影4例,瘤颈残余5例.8例(38.1％)患者发生并发症,5例发生于围手术期(2例死亡),3例发生于随访期(1例死亡);支架辅助弹簧圈栓塞组7例(2例死亡),单纯弹簧圈组1例(死亡);出血性并发症3例,缺血性并发症5例.术后19例影像学随访时间为12～62个月(中位时间为16个月).7例单纯支架置入者中,瘤体不显影4例,瘤颈残余2例,复发1例;12例支架联合弹簧圈栓塞者中,8例瘤体不显影,3例瘤颈残余,1例复发.19例临床随访22～110(64.6±19.9)个月,末次随访时预后良好[改良Rankin量表评分(mRS)≤2分]17例(81.0％).结论 血管内治疗BDA短期和长期疗效均较好,但并发症发生率较高.

abstractsObjective To explore the safety and efficacy of intravascular treatment of basilar artery dissecting aneurysms (BDA).Methods The clinical data and follow-up results of 21 patients with BDA treated at Department of Cerebrovascular Hybrid Surgery,Henan Provincial People's Hospital from January 2009 to June 2014 were retrospectively analyzed to explore the short-term (≤ 1 year) and long-term (＞ 3 years) outcome.Results Among 21 patients,7 were treated with stent-only technique and all of them showed partially developed immediately after operation.Fourteen cases were treated with stent-assisted coiling and included 5 with non-development,4 with partial developed and 5 with neck residual.Complications occurred in 8 (38.1％) cases till the last follow-up.Among them,5 had complications during perioperative period (2 deaths) and 3 reported complications during follow-up period (1 death).Seven cases were in the stent-assisted coiling group (2 deaths) and 1 was in the stent-only group (death).Hemorrhagic complications occurred in 3 cases and ischemic complications in 5 cases.Postoperative imaging follow-up lasted for 12-62 months with the median of 16 months in 19 cases.Among the 7 patients with stent-only,4 cases had complete occlusion,2 reported neck residual and 1 case developed recurrence.Among the 12 patients with stent-assisted coiling,8 cases showed complete occlusion,3 cases had neck residual and 1 had recurrence.The clinical follow-up was performed in 19 cases for 22-110 (64.6 ± 19.9) months,and the good outcome [modified Rankin Scale (mRS) ≤2] was achieved till the last follow-up in 17 (81.0％) cases.Conclusion Endovascular treatment of BDA seems to have good short-term and long-term efficacy.However,the incidence of complications could be high.