前交通动脉瘤微弹簧圈栓塞治疗效果研究  

Therapeutic efficacy of embolization with microcoils in the treatment of anterior communicating artery aneurysms

作　　者：黄庆[1] 李铁林[1] 段传志[1] 汪求精[1] 尹方明[1] 方兵[1] 赵庆平[1] 郭元星[1] 

机构地区：[1]第一军医大学珠江医院神经外科,广东广州510282

出　　处：《中华神经医学杂志》2004年第5期350-352,共3页Chinese Journal of Neuromedicine

摘　　要：目的 探讨前交通动脉瘤微弹簧圈栓塞治疗的填充比例与动脉瘤治疗效果的相关性。方法 回顾109例行介入治疗的前交通动脉瘤病人,利用动脉瘤和微弹簧圈体积计算公式获得每一患者的体积栓塞比。结果 109例均成功栓塞,其中100％闭塞97例,95％～98％闭塞12例。108例治疗后痊愈,1例死亡。32例行脑血管造影随访(随访时间3周～30个月),30例动脉瘤完全闭塞或消失,2例复发。动脉瘤微弹簧圈的实际栓塞体积比平均为27.96％,最低为7.38％,最高为74.90％。结论 多数前交通动脉瘤可经血管内栓塞治愈,从DSA影像上达到完全栓塞的动脉瘤实际栓塞体积多在50％以下,栓塞体积超过50％的多引起梗塞等并发症,故建议栓塞时不超过动脉瘤体积的50％,提出“最佳栓塞体积比”的概念。Objective To study the relativity between the embolism ratio by microcoils in anterior communicating artery aneurysms (ACoA.AN) and the therapeutic efficacy. Methods 109 ACoA.AN cases undergoing interventional therapy by embolizing microcoils in ACoA were reviewed retrospectively. Embolization volume proportions were obtained by establishing a formula concerning aneurysm volume and microcoil volume from all cases. Results 109 cases received successful embolization, of which 97 aneurysms were 100% embolized and 12 cases 95%～98% embolized. 108 cases got cured and 1 died after interventional interference. 32 cases achieved follow-up by DSA(3 weeks-30 months): 30 cases were cured fully and 2 recurred. The actual volume ratio between aneurism and embolized microcoils averaged 27.96% with the minimum 7.38% and maximum 74.90%. Conclusion Most of ACoA.ANs can be cured by endovascular embolization. The actual volume ratio between the microcoils and the aneurysms completely embolized by DSA, was under 50% in most cases. In the case of more than 50%, the complications like infarctions may occur frequently. So we suggest the proposal of 'best embolic volume ratio between the microcoils and the aneurysms', or at least under 50%.

关 键 词：微弹簧圈栓塞 前交通动脉瘤 治疗效果 并发症 闭塞 治疗后 梗塞 消失 体积 

分 类 号：R739.4[医药卫生—肿瘤]