血管内治疗椎基底动脉夹层动脉瘤 附45例分析

　　3.3 载瘤动脉闭塞术 通过阻断近端血流进入瘤腔，而避免发生再出血。但该技术同时闭塞了责任动脉，对双侧椎动脉、对侧椎动脉发育不全、累及PICA及基底动脉者，可能导致病人因缺乏足够的血供代偿，造成严重并发症。支架置入后支架内腔填塞弹簧圈以闭塞载瘤动脉，是对该项技术的改进。我们针对动脉瘤体较大，占位效应明显或血管腔形状不利弹簧圈固定的夹层动脉瘤，先置入支架，再在支架内腔成篮填塞弹簧圈，从而闭塞载瘤动脉。该项改进减少了弹簧圈的消耗，增强了弹簧圈置入后的稳定性。总之，载瘤动脉闭塞术是健侧椎动脉发育良好，特别是经济困难的VDA病人重要的治疗手段。本组6例病人采用该项技术，术后即刻造影及随访结果再次验证了该项技术的可行性和实用性。

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