弹簧圈栓塞颅内破裂微小动脉瘤的疗效观察  

Clinical observation of coil embolization of ruptured tiny intracranial aneurysms

作　　者：黄理金[1] 文军[1] 黄伟佳[1] 钟兵[1] 张晓斌[1] 石小峰 叶宇 欧阳锡华 陈委 纠智松 

机构地区：[1]南方医科大学第三附属医院介入科神经外科,广州510630 [2]深圳龙岗中心医院神经外科

出　　处：《中国脑血管病杂志》2012年第7期347-351,共5页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨血管内介入栓塞治疗颅内破裂微小动脉瘤的可行性及疗效。方法回顾性分析11例颅内破裂微小动脉瘤患者的临床资料。均由CT证实为蛛网膜下腔出血,并经DSA证实后实施了微弹簧圈栓塞治疗。结果①本组有前交通动脉动脉瘤9例,脉络膜前动脉瘤1例,胼周动脉瘤1例。入院时Hunt-Hess分级Ⅰ级3例,Ⅱ级5例,Ⅲ级2例,Ⅳ级1例。②11例均被栓塞成功,其中被完全栓塞6例,次全栓塞5例,在术后3～6个月的DSA随访中,显示这5例完全闭塞。术后格拉斯哥预后评分(GOS)5分的有9例,4分的有1例,死亡1例。无技术相关并发症。③术后3～6个月DSA随访6例,MRA随访2例,电话随访2例。有影像资料的随访病例显示,动脉瘤均被完全闭塞;电话随访患者GOS均为5分,无再出血。结论微弹簧圈栓塞颅内前循环微小动脉瘤安全、可行,短期随访结果显示效果良好。Objective To investigate the feasibility and efficacy of endovascular embolization of ruptured tiny intracranial aneurysms. Methods The clinical data of 11 patients with ruptured tiny in- tracranial aneurysm were analyzed retrospectively. All the patients with subarachnoid hemorrhage （SAH） were diagnosed by CT and microcoil embolization was performed after being confirmed by digital subtrac-tion angiography （DSA）. Results ①Nine patients had anterior communicating artery aneurysm, 1 had anterior choroidal artery aneurysm, and 1 had pericallosal artery aneurysm. At admission, the Hunt-hess grade Ⅰ was 3 cases, grade Ⅱ was 5, grade Ⅲ was 2, and grade 1V was 1. ②All the patients were embolized successfully, 6 of them were embolized completely, and 5 were embolized incompletely （during 3 to 6 months DSA follow-up, they were all obliterated completely）. The GOS were 5 in 9 pa-tients, GOS 4 in 1 patient, and 1 patient died after the procedure. No technology-related complications were observed. ③At 3 to 6 months after procedure, 6, 2, and 2 patients were followed up with DSA, magnetic resonance angiography （MRA） or telephone respectively. The aneurysms were all obliterated completely, the GOS were 5 in all patients, and no rebleeding occurred. Conclusion Endovascular embolization of ruptured tiny intracranial aneurysms in intracranial anterior circulation is safe and feasi-ble, and the result of short-term follow-up is good.

关 键 词：颅内动脉瘤 破裂 栓塞 治疗性 微小动脉瘤 

分 类 号：R743.3[医药卫生—神经病学与精神病学]