辅助栓塞技术治疗颅内复杂动脉瘤的临床应用（附36例报告）  

Assisted coiling techniques in treatment of intracranial complex aneurysms

作　　者：潘剑威[1] 欧昌江[1] 严敏[1] 范卫健[1] 贺红卫[2] 吴中学[2] 詹仁雅[1] 

机构地区：[1]浙江大学医学院附属第一医院神经外科,杭州310003 [2]北京市神经外科研究所

出　　处：《中华神经外科杂志》2011年第5期570-573,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨多种辅助栓塞技术治疗颅内复杂动脉瘤的临床应用。方法共36例患者的41个颅内复杂动脉瘤行辅助栓塞治疗，方法包括球囊、支架辅助栓塞和双微导管栓塞技术。结果宽颈动脉瘤33个，其中球囊辅助栓塞11例，完全栓塞7例，次全栓塞3例，另外1例因球囊放置困难改用双微导管栓塞技术；支架辅助栓塞15例，完全栓塞10例，次全及部分栓塞各2例，单纯支架植入1例；双微导管技术栓塞8例，完全栓塞6例，次全及部分栓塞各1例。梭形动脉瘤8个，全部行支架辅助栓塞，完全栓塞1例，次全栓塞6例，单纯支架植入1例。3例出现并发症，其中术中血栓形成2例，术后视野缺损1例。结论球囊、支架辅助和双微导管栓塞技术是治疗颅内复杂动脉瘤安全有效的方法，具体应根据动脉瘤部位、形态和患者临床情况进行选择。Objective To investigate the application of assisted coiling techniques in the treatment of complex intracranial aneurysms. Methods From Jun. 2007 to Aug. 2010, 36 patients with 41 complex intraeranial aneurysms were treated by varient endovascular methods, including balloon, stent-assisted coiling and double microcatheter coiling techniques. Results Among the 33 wide - neck aneurysms, 11 cases underwent balloon -assisted coiling, in which 7 were totally occluded, 3 subtotally occluded, 1 diverted to double microcathcter treatment after failure balloon placement. 15 cases underwent stent - assisted coiling, in which 10 were totally occluded, 2 subtotally or partially occluded respectively, 1 by single stent placement without coiling. 8 cases accepted double microcatheter treatment, 6 were totally occluded, 1 subtotally occluded and 1 partially occluded. All 8 fusiform aneurysms were treated by stent - assisted coiling, one case was totally occluded, 6 subtotally occluded, and another one was treated by single stent placement. The complications were found in 3 patients, including intra - operative thrombosis in 2 cases and dysopia in one case. Conclusion Balloon, stent - assisted coiling and double microcatheter techniques are safe and effective in treating complex intracranial aneurysms, but it should be determined by the position and morphologie characteristics of aneurysms as well as the patients＇ clinical condition.

关 键 词：复杂动脉瘤 球囊 支架 双微管 

分 类 号：R743[医药卫生—神经病学与精神病学]