Abstract：
OBJECTIVE: To investigate the effect of endovascular embolization of posterior communicating artery (Pcom) aneurysms on concomitant oculomotor nerve palsy (OMNP) and factors affecting the effect of treatment.
METHODS: Patients with the Pcom aneurysms concomitant with OMNP were retrospectively enrolled for endovascular treatment of the aneurysms. All patients had the endovascular management. The clinical effect, degree of OMNP, size of the aneurysm, type of treatment, subarachnoid hemorrhage (SAH), and time from onset to treatment were analyzed on the resolution of OMNP.
RESULTS: Ninety-six patients with 99 Pcom aneurysms were enrolled and treated endovascularly, with the success rate of 100%. Immediately after endovascular treatment, 75 aneurysms (75.75%) got complete occlusion, and 24 (24.24%) nearly complete occlusion. Followed up for 3-18 (mean 8.52±0.56) months, complete resolution of the OMNP was achieved in 63 patients (65.63%), partial resolution in 21 (21.88%), and non-recovery in the other 12 (12.50%). The degree of OMNP at onset, SAH, and time from onset to treatment were significantly (P<0.05) correlated with the resolution of OMNP. Univariate analysis revealed that younger age of the patient, degree of OMNP at onset, presence of subarachnoid hemorrhage, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. Multivariate analysis revealed that the younger age, degree of OMNP at onset, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP.
CONCLUSIONS: Endovascular embolization of Pcom aneurysms concomitant with OMNP can effectively improve the OMNP symptoms, especially for patients with moderate and a shorter history of OMNP. Younger age, degree of oculomotor nerve palsy at onset, and time from onset to treatment may significantly affect recovery of oculomotor nerve palsy.
METHODS: Patients with the Pcom aneurysms concomitant with OMNP were retrospectively enrolled for endovascular treatment of the aneurysms. All patients had the endovascular management. The clinical effect, degree of OMNP, size of the aneurysm, type of treatment, subarachnoid hemorrhage (SAH), and time from onset to treatment were analyzed on the resolution of OMNP.
RESULTS: Ninety-six patients with 99 Pcom aneurysms were enrolled and treated endovascularly, with the success rate of 100%. Immediately after endovascular treatment, 75 aneurysms (75.75%) got complete occlusion, and 24 (24.24%) nearly complete occlusion. Followed up for 3-18 (mean 8.52±0.56) months, complete resolution of the OMNP was achieved in 63 patients (65.63%), partial resolution in 21 (21.88%), and non-recovery in the other 12 (12.50%). The degree of OMNP at onset, SAH, and time from onset to treatment were significantly (P<0.05) correlated with the resolution of OMNP. Univariate analysis revealed that younger age of the patient, degree of OMNP at onset, presence of subarachnoid hemorrhage, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP. Multivariate analysis revealed that the younger age, degree of OMNP at onset, and time from disease onset to treatment were significantly (P<0.05) associated with the recovery of OMNP.
CONCLUSIONS: Endovascular embolization of Pcom aneurysms concomitant with OMNP can effectively improve the OMNP symptoms, especially for patients with moderate and a shorter history of OMNP. Younger age, degree of oculomotor nerve palsy at onset, and time from onset to treatment may significantly affect recovery of oculomotor nerve palsy.
摘要：
目的：探讨后交通动脉(Pcom)动脉瘤血管内栓塞治疗合并动眼神经麻痹(OMNP)的效果及影响治疗效果的因素。
方法：回顾性纳入Pcom动脉瘤合并OMNP的患者进行动脉瘤的血管内治疗。所有患者均接受了血管内治疗。临床效果,OMNP的程度，动脉瘤的大小,治疗类型,蛛网膜下腔出血(SAH),分析从发病到治疗的时间对OMNP的分辨率。
结果：纳入了96例Pcom动脉瘤患者，并进行了血管内治疗，成功率100%。血管内治疗后立即，75个动脉瘤（75.75%）完全闭塞，24例（24.24%）接近完全闭塞。随访3～18(平均8.52±0.56)个月,63例患者（65.63%）实现OMNP完全缓解，21的部分分辨率（21.88%），和其他12个（12.50%）未恢复。OMNP开始时的程度，SAH,从发病到治疗的时间与OMNP的消退有显著相关性(P<0.05)。单因素分析显示，患者年龄较小，OMNP发作时的程度，蛛网膜下腔出血的存在，从发病到治疗的时间与OMNP的恢复显著相关(P<0.05)。多变量分析表明，年龄越小，OMNP发作时的程度，从发病到治疗的时间与OMNP的恢复显著相关(P<0.05)。
结论：血管内栓塞治疗伴OMNP的Pcom动脉瘤可有效改善OMNP症状。特别是对于中度和较短OMNP病史的患者。年龄更小,动眼神经麻痹发作时的程度，从发病到治疗的时间可能显著影响动眼神经麻痹的恢复。
方法：回顾性纳入Pcom动脉瘤合并OMNP的患者进行动脉瘤的血管内治疗。所有患者均接受了血管内治疗。临床效果,OMNP的程度，动脉瘤的大小,治疗类型,蛛网膜下腔出血(SAH),分析从发病到治疗的时间对OMNP的分辨率。
结果：纳入了96例Pcom动脉瘤患者，并进行了血管内治疗，成功率100%。血管内治疗后立即，75个动脉瘤（75.75%）完全闭塞，24例（24.24%）接近完全闭塞。随访3～18(平均8.52±0.56)个月,63例患者（65.63%）实现OMNP完全缓解，21的部分分辨率（21.88%），和其他12个（12.50%）未恢复。OMNP开始时的程度，SAH,从发病到治疗的时间与OMNP的消退有显著相关性(P<0.05)。单因素分析显示，患者年龄较小，OMNP发作时的程度，蛛网膜下腔出血的存在，从发病到治疗的时间与OMNP的恢复显著相关(P<0.05)。多变量分析表明，年龄越小，OMNP发作时的程度，从发病到治疗的时间与OMNP的恢复显著相关(P<0.05)。
结论：血管内栓塞治疗伴OMNP的Pcom动脉瘤可有效改善OMNP症状。特别是对于中度和较短OMNP病史的患者。年龄更小,动眼神经麻痹发作时的程度，从发病到治疗的时间可能显著影响动眼神经麻痹的恢复。
