中国脑血管病杂志2011，Vol.8Issue(12)：626-631,6.DOI:10.3969/j.issn.1672-5921.2011.12.003
脑硬膜颞浅动脉血管融通术或联合血管内栓塞治疗烟雾病合并动脉瘤患者的疗效
Clinical observation of encephalo-duro-arterio-synangiosis or in combination with endovascular embolization for patients with moyamoya disease complicating intracranial aneurysms
摘要
Abstract
Objectives To observe the efficacy of encephalo-duro-arterio-synangiosis (ED AS) or in combination with endovascular embolization in the treatment of patients with moyamoya disease complicating intracranial aneurysms and to investigate the therapeutic strategy for moyamoya disease complicating in-tracranial aneurysms. Methods A total of 27 patients (28 aneurysms) with moyamoya disease complica-ting intracranial aneurysms confirmed by cerebral angiography were recruited. Nineteen patients were pres-ented as hemorrhagic disease and 8 patients were presented as cerebral ischemic disease. For 10 patients with arterial trunk aneurysms,they were treated with endovascular embolization, and then were treated with unilateral EDAS 7-10 days after embolization. Three months later the contralateral EDAS were performed. As for the aneurysms located in the peripheral arteries (n= 17), if the embolization could be performed (n =9) , the aneurysms were obliterated with coils or ONYX glue,otherwise the ipsilateral EDAS should be performed (re =8). Results ①Eighteen aneurysms in 19 patients (20 aneurysms) were embolized suc-cessfully and 2 patients were failed (one aneurysm in lenticulostriate artery and the other in posterior choroi-dalartery).After embolization, 3 patients with peripheral aneurysms had contralateral limb weakness, and recovered within 1 week to 3 months. ②There was no bleeding and rebleeding for 10-60 months follow-up after EDAS. Among the patients with cerebral ischemia, 2 had recurrence of TIA within 3 months after ED AS, but they had no recurrence of the symptom after 3 months. ③The angiography of 21 patients (21 aneurysms) 3 to 15 months after EDAS showed that the aneurysms treated with embolization did not reoccur (12 aneurysms); 8 of 9 peripheral aneurysms without embolization were disappeared; and significant reten-tion of contrast agent in 1 aneurysm was found. All 21 patients showed better communication between the superficial temporal artery and intracranial angiogenesis. Conclusion Endovascular embolization is one of the important means for the treatment of moyamoya disease complicating intracranial aneurysms. EDAS may promote the occlusion of peripheral aneurysms.关键词
脑底异常血管网病/颅内动脉瘤/脑血管重建术/栓塞,治疗性Key words
Moyamoya disease/ Intracranial aneurysm/ Cerebral revascularization/ Embolization, thera-peutic引用本文复制引用
史万超,段炼,杨日淼,咸鹏,杨伟中,张正善,冯捷,韩聪..脑硬膜颞浅动脉血管融通术或联合血管内栓塞治疗烟雾病合并动脉瘤患者的疗效[J].中国脑血管病杂志,2011,8(12):626-631,6.基金项目
国家自然科学基金资助项目(81171083) （81171083）
首都医学发展科研基金重点项目(2007-2028) （2007-2028）
