脑破裂动脉瘤早期电解可脱弹簧圈的栓塞治疗  

Experience of early embolization of ruptured intracranial aneurysms with GDC

作　　者：钟鸣[1] 谭显西[1] 李则群[1] 范良好[2] 章运军[2] 

机构地区：[1]浙江温州医学院附属一院神经外科,325000 [2]浙江温州医学院附属一院放射科,325000

出　　处：《中华急诊医学杂志》2004年第3期178-179,共2页Chinese Journal of Emergency Medicine

基　　金：国家"十五"科技攻关项目 ( 2 0 0 1BA70 3B18)

摘　　要：目的　总结颅内动脉瘤破裂早期用电解可脱弹簧圈 (GDC)栓塞治疗经验。方法　 4 7例破裂早期的颅内动脉瘤采用经股或颈动脉Seldinger s技术 ,全部用GDCl0系统和弹簧圈进行动脉瘤囊内栓塞。动脉瘤位置 :前循环动脉瘤 4 5个、后循环动脉瘤 4个。其中 2例为多发动脉瘤。动脉瘤体积均属小型 (<10mm)。结果　动脉瘤腔闭塞 10 0 %的 18个、闭塞 95 %的 2 0个 ,90 % 11个。死亡 2例 ,占 4 3%。 1例栓塞术后 36h再出血 ,行再次开颅动脉瘤夹闭术。重残 1例、轻残 2例 ,其余均恢复正常。随访 0 5～ 2年无再出血。Objective To sum up the experiences of early endovascutar embolization of ruptured intracranial aneurysms .Methods 47 cases were treated with GDC10 coil to embolize the anuerysmal sac by carotid and femoral artery approach. The site of the aneurysms were ACoA in 20 cases,PCoA in 23 cases, BVA 2 cases and MCA 2 cases.2 cases were found to have 2 aneunysms. 15 cases were classified as Hess & Hunt Grade Ⅰ, 17 as Grade Ⅱ, 10 as Grade Ⅲ, 5 as Grade Ⅳ. Results 18 aneurysms were completely occluded, 20 were 95% occluded, 11 were 90% occluded, and two deaths. Rebleeding occurred in 1 patient treated 36 hours before, the anextrysm was clipped again. Severe neurological deficits occurred in 1 case, slight neurological deficits in 2 cases, the rest were normal.No case reblecded during 0.5～2 year follow up. Conclusion Early endovasculare embolization with GDC is a good choice for ruptured intracranial aneurysms.

关 键 词：颅内动脉瘤 脑破裂 可脱弹簧圈 栓塞治疗 GDC 蛛网膜下腔出血 

分 类 号：R651.1[医药卫生—外科学]