颅内动脉瘤血管内栓塞治疗的临床效果(英文)  

Endovascular embolization treatment of intracranial aneurysms

作　　者：段传志[1] 何旭英[1] 李铁林[1] 汪求精[1] 徐如祥[1] 

机构地区：[1]南方医科大学珠江医院神经外科,广州510282

出　　处：《中华神经医学杂志》2005年第4期369-373,共5页Chinese Journal of Neuromedicine

摘　　要：目的探讨可脱性弹簧圈及可脱性球囊血管内栓塞治疗颅内动脉瘤的效果及技术要点。方法对1328例来自华南地区部分省市的颅内动脉瘤应用微导管技术,在数字减影血管造影监视下行血管内栓塞治疗,其中85例90个动脉瘤用机械式可脱性弹簧圈(MDS)栓塞,825例847个动脉瘤用电解式可脱性弹簧圈(GDC)栓塞。67例巨大动脉瘤中37例用可脱性球囊闭塞载瘤动脉,18例用GDC,11例用EDC,1例用MDS闭塞载瘤动脉。结果成功栓塞1328例1370个动脉瘤,1322例痊愈,6例死亡。栓塞程度:100%栓塞1281个(包括载瘤动脉闭塞者),95%栓塞65个,90%栓塞20个,80%栓塞4个。术中动脉瘤破裂9例,并发脑梗死5例,1例微弹簧末端逸出并顽固性脑血管痉挛。2例复发者再给予GDC栓塞而治愈。结论血管内栓塞治疗颅内动脉瘤是一种比较安全、可靠、有效的治疗手段,动脉瘤较大者,术后复发率高;术前反复蛛网膜下腔出血者,术中动脉瘤破裂的可能性较大。Objective To evaluate the effect of endovascular embolization on intracranial aneurysms with detachable coil and detachable balloon and to emphasize the mainpoint of embolization technique. Methods 1 328 patients underwent complete cerebral angiography using microcatheter under DSA imaging. 85 cases with 90 aneurysms were embolized by MDS, 825 cases with 847 aneurysms were embolized by GDC, 418 cases with 433 aneurysms were embolized by EDC. 37 of 67 giant aneurysms were embolized by detachable balloon, 18 aneurysms by GDC, 11 aneurysms by EDC, 1 by MDS. Results 1 328 patients with 1 370 aneurysms were cured successfully; 1 322 cases recovered clinically, 6 patients died. 1 281 aneurysms achieved 100 % occlusion, 65with 95 % occlusion, 20 with 90 % occlusion, and 4 with 80 % embolization. 9 aneurysms reputured during the embolization, 5 patients had cerebral infarction, 1 patient died of intractable cerebral vasospasm for microcoil escape. 2 recurrent cases were cured by second GDC embolization. Conclusion The method of endovascular embolization to treat intracranial aneurysm is safe, reliable and effective. Those cases with giant aneurysms will have high recurrence. Patients who suffer from SAH repeatedly may have great possibility of aneurysm rupture during embolization.

关 键 词：血管内栓塞治疗 颅内动脉瘤 临床效果 电解式可脱性弹簧圈 数字减影血管造影 闭塞载瘤动脉 蛛网膜下腔出血 可脱性球囊 动脉瘤破裂 微导管技术 巨大动脉瘤 脑血管痉挛 术后复发率 技术要点 华南地区 治疗手段 GDC 机械式 

分 类 号：R739.4[医药卫生—肿瘤]