载瘤动脉闭塞术治疗颅内巨大动脉瘤的探讨  

A study of intracranial giant aneurysm treatment by parent arterial occlusion

作　　者：王威[1] 宋冬雷[1] 冷冰[1] 徐斌[1] 王启弘[1] 杨晨[1] 

机构地区：[1]复旦大学附属华山医院神经外科

出　　处：《中华神经外科杂志》2007年第11期833-836,共4页Chinese Journal of Neurosurgery

摘　　要：目的总结和探讨脑血管造影和载瘤动脉闭塞在治疗颅内巨大动脉瘤上的作用及特点。方法60例颅内巨大动脉瘤患者,根据其脑血管造影的特点采取血管内介入方法[可脱式球囊和(或)弹簧圈]闭塞载瘤动脉近端53例、闭塞载瘤动脉两端后孤立动脉瘤7例;其中23例闭塞前先行颅内-外血管搭桥术。结果出院时Rankin评分分级:单纯血管内介入治疗组37例中轻残3例,合并颅内-外血管搭桥术组23例中死亡1例、重残2例。1-6年的影像学随访动脉瘤无复发。结论血管内介入结合颅内-外血管搭桥术闭塞载瘤动脉是治疗颅内巨大动脉瘤的方法之一。Objective To study the effects and features of intracranial giant aneurysm treatment by means of DSA and parent arterial occlusion. Methods An analysis was made on the clinical data of 60 patients. 53 patients were treated with proximate parent arterial occlusion by intervention （balloon and/or coil）, 7 patients with aneurysm isolation by intervention. Among whom 23 patients were combined with extra-intracranial bypass. Results Rankin scores： among the 37 patients of only intervention, 3 patients were fair incomplete; among the 23 patients of combination of intervention and extra-intracranial bypass, 1 patient died and 2 patients were heavy incomplete. 1-6 year follow-ups were made, there was no recurrence. Conclusion The combination of parent arterial occlusion by intervention with extra- intracranial bypass is the first choice of intracranial giant aneurysm treatment, with features of minor wounds and fine prognosis.

关 键 词：颅内动脉瘤 载瘤动脉闭塞 血管内介入 颅内-外血管搭桥 

分 类 号：R651.12[医药卫生—外科学]