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首页> 外文期刊>Surgical neurology >Vertebrobasilar junction aneurysms associated with fenestration: experience of five cases treated with Guglielmi detachable coils.
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Vertebrobasilar junction aneurysms associated with fenestration: experience of five cases treated with Guglielmi detachable coils.

机译：开窗相关的椎基底动脉交界性动脉瘤：5例使用古列尔米可分离线圈治疗的经验。

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摘要

BACKGROUND: Fenestration of vertebrobasilar junction is a rare congenital anomaly and often associated with aneurysm formation. We describe five cases of vertebrobasilar junction aneurysms in four patients associated with fenestration, which were treated with endovascular coil occlusion using Guglielmi detachable coils (GDCs). The importance of preoperative computed tomography (CT) angiography to understand the complex anatomy of fenestration and aneurysm is emphasized. CASE REPORTS: Three patients presented with subarachnoid hemorrhage and one patient presented with headache only. Among 3 patients with subarachnoid hemorrhage, 1 patient was referred for endovascular coil occlusion after clipping of ruptured distal ACA aneurysm. A six-French guiding catheter was placed in the left vertebral artery via right femoral artery, except for 1 patient who had two vertebrobasilar junction aneurysms with complex anatomic relationship, accessed bilaterally. Five vertebrobasilar junction aneurysms with fenestration were treated with endovascular coil occlusion using GDCs. Postoperative angiography demonstrated successful occlusion of aneurysmal sac with preservation of basilar artery. CONCLUSIONS: Vertebrobasilar junction aneurysms are frequently associated with fenestrations. In addition to vertebral angiography on both sides, CT angiography may be a valuable tool for better understanding of complex anatomy of aneurysms associated with fenestration. The surgically difficult aneurysms such as vertebrobasilar junction aneurysm with fenestration can be successfully treated with GDCs.
机译：背景：椎基底动脉交界处的开孔是一种罕见的先天性异常，通常与动脉瘤形成有关。我们描述了四例与开窗有关的患者中的五例椎基底动脉交界性动脉瘤，这些患者使用Guglielmi可拆式线圈（GDC）进行血管内线圈闭塞治疗。强调了术前计算机断层扫描（CT）血管造影对了解开窗和动脉瘤的复杂解剖结构的重要性。病例报告：3例出现蛛网膜下腔出血，1例仅出现头痛。在3例蛛网膜下腔出血患者中，有1例因切除远端ACA动脉瘤破裂而被称为血管内线圈阻塞。一条六法制导尿管经右股动脉放置在左椎动脉中，除了1名患者有两个具有复杂解剖关系的椎基底动脉连接动脉瘤，双侧入路。使用GDC对5例开窗的椎基底动脉交界动脉瘤进行了血管内线圈闭塞治疗。术后血管造影显示动脉瘤囊成功闭塞并保留了基底动脉。结论：椎基底基底交界性动脉瘤常与开窗有关。除了两侧的椎骨血管造影之外，CT血管造影可能是更好地了解与开窗有关的动脉瘤的复杂解剖结构的有价值的工具。手术困难的动脉瘤，如开窗的椎基底基底连接动脉瘤，可以成功地用GDCs治疗。

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