弹簧圈栓塞治疗颅内微小动脉瘤及中长期随访  

Coil embolization for very small cerebral aneurysms:Mid-and long-term follow-up

作　　者：孙文萍[1] 方淳 李明华[1] 朱悦琦[1] 谭华桥[1] 王珏[1] 

机构地区：[1]上海交通大学附属第六人民医院介入影像科,上海200233

出　　处：《中国介入影像与治疗学》2011年第3期175-178,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的评价弹簧圈栓塞治疗颅内微小动脉瘤（VSCAs）的有效性及稳定性。方法 19例患者（20枚VSCAs）接受血管内弹簧圈栓塞治疗。对其中9枚动脉瘤使用单纯弹簧圈栓塞,9枚使用支架辅助弹簧圈栓塞,2枚使用球囊辅助弹簧圈栓塞。根据DSA表现,将栓塞程度分为完全栓塞、次全栓塞和部分栓塞。术后进行中长期随访并收集DSA及临床结果。结果所有VSCAs均获成功栓塞。术后即刻DSA显示,20枚VSCAs中5枚为完全栓塞,9枚为次全栓塞,6枚为部分栓塞。1~2年随访DSA示20枚VSCAs均完全栓塞,未发现动脉瘤复发及弹簧圈脱出、移位。临床随访显示所有患者均未出现动脉瘤再次破裂出血及神经系统缺血症状。结论血管内弹簧圈栓塞治疗VSCAs有效、稳定;中长期随访证实次全及部分栓塞的患者可发展为完全栓塞。Objective To evaluate the feasibility and efficacy of endovascular coil embolization in the treatment of very small cerebral aneurysms（VSCAs）.Methods Nineteen patients with 20 VSCAs received endovascular coil embolization,including simple coil embolization in 9 aneurysms,stent-assisted coil embolization in 9 and balloon-assisted coil embolization in 2.According to DSA assessment,the occlusion degrees were categorized as total,subtotal or partial occlusion.Mid-and long-term follow-up was performed after the procedures to collect the data on angiographic and clinical results.Results All VSCAs were successfully embolized with coils.Immediate DSA showed total occlusion in 5 patients,subtotal occlusion in 9 and partial occlusion in 6.During 1—2 years of follow-up,complete occlusions of all VSCAs were confirmed with control angiography.No recurrence or coil compaction occurred.Clinical follow-up showed no rebleeding nor ischemic stroke occurred.Conclusion Endovascular coil embolization in the treatment of VSCAs has good efficacy and feasibility.Subtotal or partial aneurysm occlusion might progress to total occlusion.

关 键 词：血管造影术 颈内动脉 颅内动脉瘤 弹簧圈 栓塞 治疗性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]