血管内栓塞治疗颅内前交通动脉瘤189例  

Endovascular embolization for anterior communicating artery aneurysms: Clinical analysis in 189 cases

作　　者：刘佳强[1] 李真保[1] 方兴根[1] 吴德刚[1] 赵心同[1] 陈三送[1] 狄广福[1] 陈建民[1] 赖年升[1] 

机构地区：[1]皖南医学院附属弋矶山医院神经外科,安徽芜湖241001

出　　处：《皖南医学院学报》2015年第2期151-154,共4页Journal of Wannan Medical College

基　　金：安徽省卫生厅应用课题(09A001)

摘　　要：目的：总结前交通动脉瘤经血管内栓塞治疗的经验和体会。方法：回顾性分析我院经血管内栓塞治疗的189例前交通动脉瘤的临床资料，造影随访3～24个月。结果：成功栓塞前交通动脉瘤189例，致密栓塞161例；瘤体少量显影12例；瘤颈少量残留16例。术中并发脑血管痉挛12例；血栓形成6例；术中破裂3例，2例因出血死亡。单纯弹簧圈栓塞治疗146例，支架辅助弹簧圈栓塞治疗宽颈动脉瘤43例。术后92例造影随访3-24个月均无再出血，14例复发，23例支架辅助治疗患者随访中均未见复发及再出血。结论：血管内栓塞治疗前交通动脉瘤疗效可靠。支架辅助弹簧圈栓塞可降低宽颈前交通动脉瘤的复发率。早期治疗，合理应用各种辅助技术，正确处理术中并发症可有效提高治疗质量并减少预后不良。Objective：To summarize the experience of endovascular embolization in treatment of anterior communicating artery aneurysm. Methods： The clinical data were retrospectively examined in 189 cases with anterior communicating artery aneurysm undergone treatment in our hospital. Results： Endo- vascular embolization achieved in the total 189 cases,in which 161 were complete occlusion, 12 were near-complete occlusion at the body and 16, at the neck of aneurysm. Intraoperatively complicated cerebral vasospasm occurred in 12 cases, thrombosis in 6, and rupture in 3. Two deaths occurred. 146 cases were managed with simple coiling embolization, and 43 with stent-assisted coil delivery to wide-necked intracranial aneurysm. By angiographic results after surgery, follow-up in 3 to 24 months showed no re-bleeding in 92 cases, yet relapse occurred in 23, and no recurrence and re-bleeding occurred in 23 cases managed with stent-assisted coil. Conclusion ： Endovascular embolization can be reliable and effective for anterior communicating artery aneurysm. Stent- assisted coil delivery may reduce the recurrent rate for wide-necked intracrauial aneurysm. Early treatment, appropriate application of assisted technique as well as active management of intraoperative complication can improve the prognosis.

关 键 词：前交通动脉瘤 血管内治疗 介入治疗 弹簧圈 支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R651.1[医药卫生—临床医学]