颅内微小动脉瘤的介入弹簧圈栓塞治疗及中期随访观察  

Interventional coil embolization for micro-intracranial aneurysms and the midterm follow-up

作　　者：周兵[1] 方淳 李明华[1] 王武[1] 徐浩文[1] 王珏[1] 张蓓蕾[1] 

机构地区：[1]上海交通大学附属第六人民医院放射科,200233

出　　处：《介入放射学杂志》2008年第12期845-849,共5页Journal of Interventional Radiology

摘　　要：目的探讨治疗微小动脉瘤的介入弹簧圈栓塞技术,并评价其临床疗效和中期随访结果。方法回顾性分析2004年至2007年在我科治疗并经系统随访的破裂微小动脉瘤患者19例,共20枚动脉瘤。其中9枚动脉瘤单纯使用弹簧圈填塞,9枚使用支架辅助弹簧圈填塞,2枚使用球囊辅助弹簧圈填塞。结果所有动脉瘤使用弹簧圈成功填塞,技术成功率100%。术后即刻造影显示动脉瘤完全闭塞5例,瘤颈残留9例,瘤腔残留6例。有3例出现弹簧圈部分遗留于载瘤动脉,未出现弹簧圈移位和血栓形成。19例患者均经历1年以上随访。临床随访显示所有患者未出现动脉瘤再次破裂出血;17例完全恢复,未遗留神经系统并发症;1例残留轻度偏瘫,1例遗留动眼神经不全麻痹。1年后造影随访显示15枚动脉瘤完全闭塞,4枚瘤颈残留,1枚瘤腔残留扩大。未发现弹簧圈脱出、移位、载瘤动脉瘤狭窄。结论介入弹簧圈填塞术治疗微小动脉瘤安全、有效,选择合适的栓塞技术是治疗的关键。Objective To discuss the coiling embolization techniques for micro-intracranial aneurysm, and evaluate the clinical efficacy and midterm follow-up. Methods From 2004 to 2007, 19 patients with 20 ruptured micro-intracranial aneurysms underwent coil embolization in our institution, including simple coil embolization in 9 aneurysms, stent-assisted coil embolization in 9 and balloon-assisted coil embolization in 2. Results All aneurysms were successfully embolized with coils. Angiography immediately after coiling procedure revealed complete occlusion in 5 aneurysms, neck remnant in 9 and residual aneurysm in 6. In 3 cases, coil can＇t be completely packed into the aneurysm and was left in the parent artery. Coil/stcnt displacement and acute thrombosis were not found. Over 1-year follow-up, aneurysm re-rupture was not found. Seventeen patients recovered without neurologic complications, the other two consisted of 1 with mild hemiparalysis and 1 with oculomotor paresis. The follow-up angiography 1 year after coiling showed complete occlusion in 15 aneurysms, neck remnant in 4 and residual aneurysm enlargement in 1. Conclusion Coil embolization for ruptured micro-intracranial ancrysm is safe and efficient, and selection of suitable coiling technique is the key to treatment.

关 键 词：微动脉瘤 弹簧圈栓塞 支架 颈残留 残余动脉瘤 

分 类 号：R743.4[医药卫生—神经病学与精神病学]