老年颅内动脉瘤患者血管内栓塞的临床研究  

Endovascular embolization for elderly patients with intracranial aneurysms

作　　者：于小千 段安安[1] 王大明[2] 刘加春[2] 姜宏志[2] 王利军[2] 陆军[2] 

机构地区：[1]北京海淀医院神经外科,100080 [2]卫生部北京医院神经外科

出　　处：《中国脑血管病杂志》2005年第7期294-297,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：首都医学发展科研基金资助项目(ZD199802);卫生部临床学科重点项目〔卫规财发(2001)321号〕

摘　　要：目的探讨老年颅内动脉瘤患者的临床、影像特点和血管内治疗方法的疗效。方法44例60岁以上患者共52个颅内动脉瘤,全部经全脑血管造影明确诊断。针对老年患者路径动脉迂曲、狭窄形成等特点,栓塞时,可采用多种入路,包括股动脉、颈动脉或肱动脉等。采用三维弹簧圈成篮技术、联合支架或球囊重塑形技术等栓塞宽颈动脉瘤和梭形动脉瘤。结果52个动脉瘤有49个被成功实施栓塞术(成功率为94.2%);44例患者术后3个月格拉斯哥预后评分(GOS)良好33例,中残6例,重残3例,死亡2例。结论血管内栓塞治疗适于合并症多、血管条件较差的老年颅内动脉瘤患者。Objective To study the angiographic and clinical characteristics, as well as endovascular treatment of intracranial aneurysms in elderly patients. Methods 52 aneurysms in 44 patients older than 60 years were diagnosed by cerebral angiography, and treated by endovascular embolization. The clinical and angiographic characteristics and the therapeutic results of these patients were analyzed retrospectively. The outcomes were evaluated by GOS three months later. In regard to the difficulties of catheter introducing in severe tortuous or stenosed arteries, we had tried many approaches during the operation, including femoral artery, carotid artery or brachium artery. Different procedures, such as basket technique with 3D coils, balloon remodeling and stent assistant remodeling techniques were tried to obliterate the wide necked aneurysms. Results 49 out of 52 aneurysms were embolized successfully(94.2%). Among these 44 patients, 33 cases were evaluated as good, 6 cases were moderately disabled, 3 cases seriously disabled and 2 died. Conclusion Embolization is a useful and suitable therapy for the aged patients with intracranial aneurysms, especially for those who are combined with other illness or their cerebral vasculars are in poor conditions.

关 键 词：颅内动脉瘤 临床研究 格拉斯哥预后评分 60岁以上患者 血管内栓塞治疗 全脑血管造影 梭形动脉瘤 宽颈动脉瘤 治疗方法 影像特点 动脉迂曲 老年患者 塑形技术 股动脉 肱动脉 弹簧圈 栓塞术 合并症 血管条 

分 类 号：R739.4[医药卫生—肿瘤]