颅内微小动脉瘤血管内介入治疗的临床疗效分析

doi:10.19854/j.cnki.1008-2425.2026.03.0007

摘要/Abstract

摘要： 目的探讨颅内微小动脉瘤血管内介入治疗的临床疗效。方法回顾性分析2020年7月至2024年6月于蚌埠医科大学第二附属医院神经外科就诊,行脑血管造影检查(DSA)明确诊断,行血管内治疗的97例颅内微小动脉瘤(瘤体直径≤3.00 mm)。病例分为未破裂组与破裂组,分别按照择期手术及急诊手术准备,统计所有病例的临床特征,采用单因素分析及多因素Logistic回归分析相关数据。动脉瘤栓塞程度即刻影像评估采用Raymond-Roy分级(R-R分级);临床预后评估采用改良Rankin量表(mRS评分),0~2分定义为预后良好,3~6分定义为预后较差。结果 97例动脉瘤均成功治疗,其中未破裂动脉瘤46例(47.42%),均预后良好;破裂动脉瘤51例(52.58%),预后良好38例(74.51%);整体预后良好84例(86.60%)。结论血管内介入治疗颅内微小动脉瘤安全可行,破裂后血管内治疗预后较差,并发症较多,未破裂患者存在相关破裂危险因素时,可建议预防性行血管内介入治疗。

关键词: 颅内微小动脉瘤, 介入治疗, 疗效, 风险因素, logistic回归

Abstract: Objective To evaluate the clinical efficacy of endovascular interventional therapy for intracranial micro-aneurysms. Methods A retrospective analysis was performed on 97 intracranial micro-aneurysms(diameter ≤3.00 mm) treated at the Department of Neurosurgery,Second Affiliated Hospital of Bengbu Medical University,between July 2020 and June 2024.After diagnostic digital subtraction angiography(DSA),all patients underwent endovascular treatment.Cases were divided into unruptured and ruptured groups,prepared for elective and emergency procedures,respectively.Clinical characteristics were collected,and univariate and multivariate logistic regression analyses were applied.Immediate angiographic occlusion was assessed using the Raymond-Roy(R-R) scale.Clinical outcome was evaluated by the modified Rankin Scale(mRS);scores of 0-2 were defined as favorable,and 3-6 as poor. Results All 97 aneurysms were successfully treated.Among them,46(47.42 %) were unruptured and achieved favorable outcomes in every case;51(52.58 %) were ruptured,with 38(74.51 %) achieving favorable outcomes.Overall,favorable outcomes were observed in 84 patients(86.60 %). Conclusion Endovascular treatment for very small intracranial aneurysms is safe and feasible.Endovascular treatment after rupture has a relatively poor prognosis with more complications.For unruptured patients with relevant rupture risk factors,prophylactic endovascular treatment may be recommended.

Key words: Micro-Intracranial Aneurysm, Endovascular Therapy, Efficacy, Risk Factors, Logistic Regression

中图分类号:

R743.4

刘烨, 程哲, 朱凯, 范顺志, 王大巍, 束汉生. 颅内微小动脉瘤血管内介入治疗的临床疗效分析[J]. 立体定向和功能性神经外科杂志, 2026, 39(3): 173-180.

Liu Ye, Cheng Zhe, Zhu Kai, Fan Shunzhi, Wang Dawei, Shu Hansheng. Clinical efficacy analysis of endovascular interventional therapy for intracranial micro-aneurysms[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2026, 39(3): 173-180.

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