如何安全有效栓塞已破裂的颅内动脉瘤  

How to healing the intracranial ruptured aneurysms safely and effectively by using the GDC endovascular embolization

作　　者：李作贵 毛善平[1] 

机构地区：[1]武汉大学人民医院神经内科,硕士研究生430060

出　　处：《卒中与神经疾病》2015年第3期152-155,共4页Stroke and Nervous Diseases

摘　　要：目的探讨应用电解可脱性弹簧圈（Guglielmi detachable coil,GDC）栓塞治疗颅内已破裂的动脉瘤（aneurysm,AN）的安全性、有效性。方法回顾性分析2007年6月～2013年12月采用GDC栓塞颅内已破裂的AN36例,前交通AN12个,后交通AN18个,大脑中AN6个,按Hunt-Hess分级：Ⅱ级15例、Ⅲ级18例、Ⅳ级3例,对部分病例辅以篮筐技术、球囊Remodeling技术、支架技术,双微导管技术以及蚕食技术。结果成功栓塞36例颅内动脉瘤,其中完全填塞31例、次全填塞4例、部分填塞1例,随访0.5～7年,除1例术后1周死亡外,其余35例均未再出血。结论根据导管操作熟练程度,医学工程所作设计理念以及术中对可能出现并发症的防范和处理能力分为各种层次,选择适应自己层次的病例,GDC栓塞颅内AN是一种安全、有效的治疗手段。Objective To explore the security and effetiveness of the endovascular embolization with Guglielmi detachable coil（GDC） in 36 patients with intracranial bursted aneurysm（AN）. Metthods From June 2007 to December 2013, we adopt the GDC embolization of intracranial ruptured AN in 36 cases, and combined baskat technique, balloon remodeling technique, stent technique, double micro-catheter technique and piecemeal technique for some cases. The locations of aneurysms were as following： 12 acses in anterior communicating ar- tery, 18 cases in posterior communicating artery and 6 cases in middle cerebral artery. Hunt-Hess grade was as following; 15 cases of grade II, 18 cases of grade III and 3 cases of grade IV. Results Thirsty-six cases with an- eurysms were successfully embolized. 31 cases were completely occluded. 4 cases were stuffing completely oc- cluded and 1 case was partially occluded. Following-up visiting from 0. 5 to 7 years, the rest of the cases were rebleeding, except 1 case died a week later. Conclusions According to the performer catheter operation profi- ciency, individualization of medical engineering design concept, and intraopertive＇s ability to prevent and deal with possible complications, therapy is divided into various levels. We should choose methods according to your levels of cases. Endovascular embolization with GDC for the treatment of cerebral aneurysm is a safe and effec- tive means, with clinical promotion.

关 键 词：颅内动脉瘤 血管内栓塞 电解可脱性弹簧圈 

分 类 号：R739[医药卫生—肿瘤]