栓塞治疗35例颅内破裂微小动脉瘤  

Endovascular embolization treatment of very tiny ruptured intracranial aneurysms: initial experience in 35 cases

作　　者：高天[1] 李冬梅 杜世伟[1] 白志峰[1] 汪晶[1] 朱海波[1] 杨杨[1] 张隆辉[1] 毛更生[1] 

机构地区：[1]中国人民武装警察部队总医院神经血管外科,北京100039

出　　处：《介入放射学杂志》2013年第12期1039-1042,共4页Journal of Interventional Radiology

摘　　要：目的 探讨血管内栓塞颅内微小动脉瘤技巧及临床效果.方法 回顾性分析2009年1月—2011年12月经血管内栓塞治疗的35例、37枚颅内微小动脉瘤患者.分析临床疗效、预后及随访结果,讨论血管内治疗颅内微小动脉瘤的安全性、有效性及操作技巧.结果 术后即刻造影发现37枚栓塞的微小动脉瘤中,达完全栓塞者27枚,动脉瘤瘤颈残留7枚,瘤腔残留3枚;30例患者获术后6～ 36个月随访,未发现动脉瘤再破裂出血.结论 血管内栓塞治疗颅内微小动脉瘤是安全有效的.应用一些手术技巧和各种栓塞材料,微小动脉瘤可以达到理想的治疗结果.Objective To explore the clinical efticacy of endovascular embohzation treatment tor very tiny ruptured intracranial aneurysms （≤ 3 mm） and to discuss its manipulation skill.Methods During the period from Jan.2009 to Dec.2011 at authors＇ institution,endovascular embolization with coils was carried out in 35 patients with very tiny ruptured intracranial aneurysms （37 lesions in total）.The clinical data were retrospectively analyzed.The clinical efficacy of the treatment,the prognosis and the follow-up results were analyzed.The safety,effectiveness and the technical skill of the therapy were discussed.Follow-up imaging examinations with magnetic resonance or angiography were performed with intervals ranging from 6 to 36 months.Angiographic results were evaluated by Raymond-Roy （RR） grading system.Clinical outcomes during the same period were determined with GOS Scale.Results Angiography performed immediately after the procedure showed that complete obstruction was obtained in 27 aneurysms,neck remnant was seen in 7 aneurysms and residual aneurysm was found in 3 aneurysms.During the follow-up period lasting for 6-36 months,no recurrence of rupture and bleeding of aneurysms was observed.Conclusion For the treatment of very tiny intracranial aneurysms,endovascular embolization is safe and effective.Satisfactory results can be achieved if proper skill and embolic agents are used.

关 键 词：微小动脉瘤 血管内栓塞 残余动脉瘤 

分 类 号：R739.41[医药卫生—肿瘤]