经颈总动脉穿刺入路治疗复杂Ⅲ型主动脉弓动脉瘤的效果分析

doi:10.3877/cma.j.issn.2095-9141.2020.06.009

中华神经创伤外科电子杂志 ›› 2020, Vol. 06 ›› Issue (06) : 364 -367. doi: 10.3877/cma.j.issn.2095-9141.2020.06.009

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经颈总动脉穿刺入路治疗复杂Ⅲ型主动脉弓动脉瘤的效果分析

李彦钊¹, 周敬斌¹, 张绪新¹, 王木春¹, 任刚¹, 邓东风¹^,^†(

)

^1. 116001　大连，大连大学附属中山医院神经外科

收稿日期:2020-07-17 出版日期:2020-12-15
通信作者: 邓东风

Treatment of complex type Ⅲ aortic arch aneurysm by common carotid artery puncture

Yanzhao Li¹, Jingbin Zhou¹, Xuxin Zhang¹, Muchun Wang¹, Gang Ren¹, Dongfeng Deng¹^,^†()

^1. Department of Neurosurgery, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China

Received:2020-07-17 Published:2020-12-15
Corresponding author: Dongfeng Deng
About author:
Corresponding author: Deng Dongfeng, Email: 18604117718@163.com

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目的

探讨经颈总动脉穿刺入路治疗复杂Ⅲ型主动脉弓动脉瘤患者的效果。

方法

回顾分析大连大学附属中山医院神经外科自2018年5月至2020年3月收治的6例复杂Ⅲ型主动脉弓患者，均行经颈总动脉穿刺动脉瘤栓塞术，观察患者的术后疗效。

结果

患者术后造影显示远端血流通畅，动脉瘤栓塞确切，出院时6例患者均恢复良好，无后遗症，GOS评分5分；随访3~23个月，患者均无不适症状。

结论

对于复杂Ⅲ型主动脉弓动脉瘤患者的微创治疗，采取经颈总动脉穿刺操作，可以获得良好的手术效果。

关键词: 复杂Ⅲ型主动脉弓, 经颈总动脉穿刺, 动脉瘤栓塞

Objective

To investigate the effect of common carotid artery puncture approach in the treatment of complex type Ⅲ aortic arch aneurysms.

Methods

Six patients with complex type Ⅲ aortic arch admitted to Neurosurgery Department of Affiliated Zhongshan Hospital of Dalian University from May 2018 to March 2020 were retrospectively analyzed. All patients were treated with common carotid artery puncture and embolization.

Results

After operation, DSA showed that the distal blood flow was unobstructed and the aneurysms were embolized accurately. Six patients recovered well at discharge without sequelae. The GOS score was 5 points. All patients were followed up for 3-23 months without any symptoms.

Conclusion

For patients with complex type Ⅲ aortic arch aneurysms, the minimally invasive treatment can obtain good surgical results.

Key words: Complex type Ⅲ aortic arch, Common carotid artery puncture, Aneurysm embolization

表1 6例复杂Ⅲ型主动脉弓动脉瘤动脉瘤患者一般资料

序列	性别	年龄（岁）	高血压	动脉瘤位置	动脉瘤大小(mm²)	动脉瘤破裂	术后GOS评分（分）
1	男	48	否	眼动脉段	2×3	否	5
2	男	51	否	后交通动脉	2.5×3	是	5
3	男	68	是	海绵窦段	3×3	否	5
4	女	43	否	海绵窦段	3×3.5	否	5
5	男	66	是	大脑中动脉	3×4	是	5
6	女	59	否	眼动脉段	2.5×3	否	5

表1 6例复杂Ⅲ型主动脉弓动脉瘤动脉瘤患者一般资料

序列	性别	年龄（岁）	高血压	动脉瘤位置	动脉瘤大小(mm²)	动脉瘤破裂	术后GOS评分（分）
1	男	48	否	眼动脉段	2×3	否	5
2	男	51	否	后交通动脉	2.5×3	是	5
3	男	68	是	海绵窦段	3×3	否	5
4	女	43	否	海绵窦段	3×3.5	否	5
5	男	66	是	大脑中动脉	3×4	是	5
6	女	59	否	眼动脉段	2.5×3	否	5

图1 典型病例6患者术前术后DSA影像学资料

[1]	Li MH, Chen SW, Li YD, et al. Prevalence of unruptured cerebral aneurysms in Chinese adults aged 35 to 75 years: a cross-sectional study[J]. Ann Intern Med, 2013, 159(8): 514-521.
[2]	Ingall T, Asplund K, Mähönen M, et al. A multinational comparison of subarachnoid hemorrhage epidemiology in the WHO MONICA stroke study[J]. Stroke, 2000, 31(5): 1054-1061.
[3]	Vlak MH, Algra A, Brandenburg R, et al. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis[J]. Lancet Neurol, 2011, 10(7): 626-636.
[4]	朱青峰，王千，王国芳,等.微弹簧圈血管内介入治疗颅内动脉瘤[J].临床军医杂志, 2009, 37(5): 821-823.
[5]	洪德全，黄海鹰，杨华,等.介入栓塞术与开颅夹闭术治疗颅内动脉瘤的疗效对比[J].中国现代医生, 2018, 56(34): 79-82, 87.
[6]	邱晓鹏.脑动脉瘤破裂开颅夹闭术与血管内介入栓塞术后发生慢性脑积水的相关因素分析[D].新乡:新乡医学院, 2018.
[7]	丛大伟.颅内破裂动脉瘤开颅夹闭术与介入栓塞术疗效的非随机对照临床试验[D].济南:山东大学, 2017.
[8]	Fargen KM, Soriano-Baron HE, Rushing JT, et al. A survey of intracranial aneurysm treatment practices among United States physicians[J]. J Neurointerv Surg, 2018, 10(1): 44-49.
[9]	童为燕，吴文俊，秦杰.经皮股动脉穿刺术后两种穿刺点压迫止血方法的效果对比[J].中国临床神经外科杂志, 2019, 24(7): 419-421.
[10]	杨增升，巩晓宁，王燕,等.颈动脉穿刺入路大脑中动脉M1闭塞机械取栓1例并文献回顾[J].卒中与神经疾病, 2019, 26(5): 531-534.
[11]	Casserly IP. Manual of peripheral vascular intervention[M]. Philadelphia: Lippincott Williams & Wilkins, 2005: 83-90.
[12]	Ray CD. Garotid artery punctures for cerebral angiography[J]. Neurology, 1965, 15: 737-743.
[13]	Bergeron P. Direct percutaneous carotid access for carotid angioplasty and stenting[J]. J Endovasc Ther, 2015, 22(1): 135-138.
[14]	Alvarez B, Matas M, Ribo M, et al. Transcervical carotid stenting with flow reversal is a safe technique for high-risk patients older than 70 years[J]. J Vasc Surg, 2012, 55(4): 978-984.
[15]	陈章强. Perclose血管缝合器和Angioseal血管封堵器在冠脉介入诊疗中的临床应用[J].中国循环杂志, 2014, z1: 77-77.
[16]	李永东，宫丽斌，陈美俊,等.人工压迫和Perclose血管缝合器的股动脉止血疗效比较[J].心血管康复医学杂志, 2014, 23(5): 563-565.
[17]	Barbash IM, Barbanti M, Webb J, et al. Comparison of vascular closure devices for access site closure after transfemoral aortic valve implantation[J]. Eur Heart J, 2015, 36(47): 3370-3379.

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