血管内栓塞治疗脑血管疾病  

Endovascular embolization of cerebral vascular diseases

作　　者：李国新[1] 王志刚[1] 宋玉宣 孙凝家[1] 曲元明[1] 

机构地区：[1]山东省立医院神经外科,济南250021

出　　处：《中国微侵袭神经外科杂志》1998年第1期20-22,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的:本文对63例脑血管疾病血管内栓塞治疗的方法、效果进行临床分析。方法:应用介入神经放射技术,将微导管送至病灶。分别以α—氰基丙烯酸异丁酯(IBCA)、α-氰基丙烯酸正丁酯(NBCA)、线段、球囊、微弹簧圈,对病灶进行栓塞治疗。结果:41例脑血管畸形完全栓塞8例,部分栓塞后手术切除4例,余均为大部分栓塞。18例颈内动脉—海绵窦瘘全部治愈,其中11例既闭塞瘘口又保持了颈内动脉通畅。4例动脉瘤中3例以微弹簧圈及可脱性球囊闭塞,1例微弹簧圈部分闭塞了瘤腔,因颈动脉痉挛而终止继续治疗。结论:血管内治疗脑血管畸形少部分可获得治愈。大部分未完全栓塞者临床症状、体征有改善,并给进一步治疗提供了有利条件。可脱性球囊栓塞颈内动脉—海绵窦瘘治愈率高,可作为首选治疗。颈内动脉虹吸段动脉瘤,以弹簧圈栓塞效果肯定。63 cases of cerebral vascular diseases treated by endovascular embolization were reported. The methods and results of treatment were studied. Method: The authors used the Magic catheter system and obliterate the feeding arteries of the AVMs or CCF. All the cases were selectively embolized with IBCA, XBCN, silk thread segment, microcoil or balloon. Result: In 41 cases with cerebral AVMs. the nidus was completely obliterated in 8 cases, subtotally or partially in the rest cases. 4 cases of AVMs embolized partially were removed during operation. In 18 cases of CCF, the fistula were occluded with the detachable balloon, and ICA patency were preserved in 11 cases. 3 cases with intracra-nial aneurysms were completely occluded and 1 case was partially occluded with microcoil or balloon. The parent arteries in 2 cases were preserved. Conclusion: Some patients with AVMs can be cured by means of endovascular embolization. In some cases only partial embolization were achieved, the clinical symptoms and signs could be improved, sometimes in such cases further treatment would be necessary. Endovascluar embolization with detechable balloon is the best choise for CCF. The embolization treatment with microcoils or balloon is usually be available for some intracranial aneurysms, especially the uncli-pable aneurysms.

关 键 词：脑动静脉畸形 颈内动脉海绵塞瘘 动脉瘤 血管内栓塞 

分 类 号：R743.4[医药卫生—神经病学与精神病学]