前循环动脉瘤的介入治疗（附40例分析）  

Interventional treatment for anterior circulation aneurysms：a report of 40 cases

作　　者：周波[1] 陈治标[1] 王军民[1] 陈谦学[1] 

机构地区：[1]武汉大学人民医院神经外科,430060

出　　处：《临床外科杂志》2014年第4期276-278,共3页Journal of Clinical Surgery

摘　　要：目的 探讨前循环动脉瘤介入栓塞的临床疗效及并发症的处理.方法 对40例前循环动脉瘤患者采用介入栓塞治疗（42枚）,其中颈内动脉动脉瘤2例（2枚）,大脑中动脉动脉瘤18例（20枚）,前交通动脉瘤15例（15枚）,大脑中-后交通动脉动脉瘤5例（5枚）.结果 介入栓塞动脉瘤40例（42个）,栓塞率达100％的36个,95％的5个,90％的1个.随访共37例,3例失访.所有患者均复查头颅CT,原则上要求均复查DSA,但5例因经济原因不愿意复查DSA.32例患者均于出院后6个月复查DSA,2例复发,其中1例弹簧圈向瘤内移位,瘤颈部位复发;复查头颅CTA的患者中1例为90％栓塞,6个月后出现瘤颈少许显影,2例患者均再次使用电解可脱式铂金螺旋圈后达100％栓塞.术后恢复良好.结论 采用电解可脱式铂金螺旋圈治疗前循环动脉瘤效果好、并发症少、恢复快,近期效果显著.Objective To investigate clinical effects and complication management in the interventional embolization for anterior circulation aneurysms.Methods A total of 40 cases（42 lesions）of anterior circulation aneurysms underwent interventional embolization,including internal carotid artery aneurysm in 2 cases（2 lesions）,middle cerebral artery aneurysms in 18 cases（20 lesions）,anterior communicating artery aneurysms in 15 cases（15 lesions）,and middle and posterior communicating artery aneurysms in 5 cases（5 lesions）.Results In the 40 cases（42 lesions）with interventional embolization,36 cases achieved a embolization rate of 100％,5 cases achieved a embolization rate of 95％,and 1 case achieved a embolization rate of 90％.All but 3 of the cases completed follow-up.Skull computed tomography （CT） was retested in all cases.In principle,digital subtraction angiography （DSA）should also be retested in all cases,but 5 patients refused it for financial reasons.The other 32 patients completed DSA and the aneurysm relapsed in 2 cases.One patient had a migration of the spring coil into the aneurysm and a recurrence in the aneurysm＇s neck.The other patient with skull computed tomography angiography（CTA） had a embolization rate of 90％ and an imaging developed in the aneurysm＇s neck after 6 months.These patients were reoperated with Gugliemi detachable coil（GDC） and achieved a embolization rate of 100％ with satisfactory postoperative recovery.Conclusion For anterior circulation aneurysms,GDC has remarkable short-term effect with few complications and quick recovery.

关 键 词：前循环动脉瘤 介入栓塞 临床疗效 

分 类 号：R739.4[医药卫生—肿瘤]