在解剖学指导下选择重建与解构的内血管策略,用于脊椎动脉内部剖析动脉瘤

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Mustafa Ismail¹, Norito Kinjo¹, Mohammed Bani Saad²

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概括

脊椎动脉剖析动脉瘤 (VADA) 的内血管治疗显示出有前途的结果. 治疗选择,就像流量转移一样,取决于动脉瘤解剖学和涉及的动脉,以获得更好的结果.

科学领域:

干预性神经放射学干预性神经放射学
血管外科血管外科
神经外科神经外科

背景情况:

脊髓动脉剖析动脉瘤 (VADA) 存在复杂的治疗挑战,特别是当关键动脉如后下脑小动脉 (PICA),前脊髓动脉 (ASA) 或主导脊髓动脉 (VA) 涉及时.
内血管方法为这些具有挑战性的病例提供了潜在的解决方案.

研究的目的:

分析影响VADA治疗决策的解剖学因素.
评估内血管治疗策略及其对VADA的临床结果.
为了确定成功的VADA管理的预测因素.

主要方法:

对从2013年1月到2025年4月前性收集的数据进行回顾.
包括接受静脉内血管治疗的成人患者.
使用12个月修改的兰金度表 (mRS) 进行初级结果评估.

主要成果:

治疗了19名患者 (平均年龄~52岁),大多数动脉瘤是状的 (63.2%),近一半呈现破裂 (42.1%).
流量转移是主要的治疗方式 (63.2%),在78.9%的患者中在12个月内获得了有利的mRS (≤2).
随着时间的推移,血管屏蔽率有所改善,结果在各种解剖学表述中是有利的,包括PICA或ASA参与和VA主导.

结论:

对VADA的最佳管理是由特定的解剖学考虑决定的.
母动脉阻塞适用于具有足够抵押的非主导动脉.
在占主导地位的VA或涉及PICA/ASA的剖析中,可能具有辅助卷轴的分支保持流量转移是首选的.

关键词:

这是一个ASA ASA.这就是PICAICA.脊椎动脉剖析动脉瘤脊椎动脉剖析动脉瘤血管内治疗治疗血管内治疗流量转移流量转移流量转移

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