一期血管内栓塞治疗颅内多发动脉瘤的临床研究  

Preliminary clinical experience of one-stage endovascular embolization for multiple intracranial aneurysms

作　　者：黄海东[1] 顾建文[1] 赵凯[1] 匡永勤[1] 杨春敏[2] 贺伟旗[1] 杨涛[1] 刘恩渝[1] 林龙[1] 邢学民[1] 程敬民[1] 

机构地区：[1]成都军区成都总医院神经外科,成都610083 [2]成都军区成都总医院医学影像科,成都610083

出　　处：《解放军医学杂志》2011年第3期287-288,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：目的总结和探讨一期血管内栓塞治疗颅内多发动脉瘤的方法及疗效。方法对2005年9月-2010年6月收治的18例颅内多发动脉瘤患者的44个动脉瘤行一期血管内栓塞治疗,其中采用单纯弹簧圈栓塞动脉瘤32个,颅内支架(LEO支架或En-terprise支架)辅助弹簧圈栓塞宽颈动脉瘤12个。术后3～12个月进行临床和影像学随访。结果全部病例栓塞成功。12枚支架到位满意。38个动脉瘤完全闭塞,5个闭塞95%以上,1个闭塞95%以下。无手术并发症,术后患者均恢复良好,临床随访3～12个月无动脉瘤再出血或脑血栓形成,其中数字减影血管造影(DSA)随访9例无动脉瘤复发及支架狭窄。结论一期血管内栓塞是治疗颅内多发动脉瘤安全有效的方法,但其长期疗效仍需进一步观察。Objective To preliminarily investigate and summarize the technique and efficacy of one-stage endovascular embolization for treatment of multiple intracranial aneurysms.Methods Eighteen patients with multiple intracranial aneurysms,in whom 44 aneurysms were found,were treated by endovascular embolization in one-stage from Sep.2005 to Jun.2009.Thirty-two aneurysms were embolized with hydro-detachable coils,and twelve wide-necked aneurysms were embolized with intracranial stents（LEO stent or Enterprise stent） combined with hydro-detachable coils.The clinical and radiological follow-up period was 3-12 months after surgery.Results Embolization was successful in all patients,and the stent placement was optimal in 12.The total occlusion of aneurysmal cavities was achieved in 38 aneurysm,more than 95% of the aneurysmal cavities were occluded in 5 aneurysms and less than 95% in 1 aneurysm.No operative complication was found and all the patients recovered well.No rebleeding or cerebral thrombosis occurred during the period of 3-12 months clinical follow-up,and no aneurysmal recurrence or in-stent stenosis was found in 9 patients followed-up by digital substraction angiography（DSA）.Conclusion Endovascular embolization in one-stage is a safe and effective technique for the treatment of multiple intracranial aneurysms,and the long-term efficacy still needs further observation.

关 键 词：颅内动脉瘤 栓塞 治疗性 手术后并发症 

分 类 号：R651.122[医药卫生—外科学]