血管内栓塞治疗颅内微小动脉瘤  

Endovascular treatment of very small intracranial aneurysms(report of 25 caese)

作　　者：熊家锐[1] 王本瀚[1] 郭效东[1] 张广林[1] 

机构地区：[1]解放军第153中心医院全军神经外科中心,郑州450042

出　　处：《中国临床神经外科杂志》2013年第7期388-390,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的总结血管内栓塞治疗颅内微小动脉瘤的效果与技术经验。方法回顾分析经血管内栓塞治疗25例(计29枚)颅内微小动脉瘤(瘤体最大长径:2～3 mm 15枚、1.6～1.9 mm 14枚),其中单纯弹簧圈栓塞10枚,球囊辅助栓塞10枚,支架辅助栓塞7枚,单纯支架覆盖瘤颈2枚。结果29枚动脉瘤术后即刻致密栓塞13枚,占44.8%。出院时按改良GOS评分评估预后,25例患者中恢复正常18例、良好2例、一般2例、差1例、死亡2例。23例患者随访6个月～4年,无再出血病例;19例(21枚动脉瘤)复查造影,其中2例(2枚)复发(给予补充致密栓塞),2例(2枚)行单纯支架覆盖瘤颈的患者见动脉瘤已闭塞。结论血管内治疗微小动脉瘤安全有效,微导管头端合理塑形与技术操作规范是治疗成功的关键。Objective To explore the curative effect of the endovascular embolization on the very small intracranial aneurysms and its technique. Methods The clinical data of 25 patients with 29 very small intracranial aneurysms （including 15 aneurysms with maximum diameter ranging from 2 mm to 3 mm and 14 aneurysms with maximum diameter 〈 2 mm） which were endovascularly embolized were analyzed retrospectively. Of 29 aneurysms, 10 were embolized by the coils, 10 by the balloon-assisted coils, 7 by the stent-assisted coils and 2 were treated by the simple stents covering aneurismal necks. Results Of 29 aneurysms, 13 were completely occluded （44.82%） and 16 incompletely. Of 25 patients, 18 were recovered well, 2 were slightly disabled, 3 moderately, 1 severely and 2 died. The following-up from 6 months to 4 years showed that rebleeding did not occur in all the survived patients, and the aneurysms recurred in 2 patients who underwent endovascular completely embolization with coils. Conclusions The endovascular embolization is a safe and effective method to treat very small intracranial aneurysms. The reasonable remodeling of the micocatheter top and skillful intervention technique are the key to the endovascylar treatment of very small intracranial aneurysms.

关 键 词：颅内微小动脉瘤 血管内治疗 效果 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]