摘要
目的评价在早期使用微弹簧栓塞治疗破裂小型颅内动脉瘤的临床效果。方法回顾分析156例（171个）小型颅内动脉瘤（直径小于10mm）在破裂后早期进行栓塞治疗及术后1～2年随访的情况。结果156例（171个）小型颅内动脉瘤，完全栓塞的91个，有瘤颈少许残留64个，瘤颈残留及不完全栓塞的16个；与手术相关并发症13例，其中1例死亡，2例有偏瘫。130例（143个）颅内动脉瘤12～24个月的随访，有1例复发出血；48个动脉瘤在12～24个月后血管造影复查，7个复发。3个栓塞后有残留的动脉瘤在1年后自行闭塞，随访造影中能观察到有新生组织完整覆盖瘤颈。结论在急性期使用微弹簧栓塞治疗破裂小型颅内动脉瘤是一种安全有效的方法，瘤颈的残留，与动脉瘤复发的关系密切，颅内支架（Neuroform）及带生物活性涂层的弹簧（Matrix）的使用，有助于减少小动脉瘤的复发率。
Objective To assess the effect of ruptured intractranial saccular aneurysms embelization with coils. Mehtods A retrospective analysis of 156 patients with 171 acute ruptured intracranial aneurysms that were small （〈 10 mm）, and were coil embolized with GDC, DCS or EDC. Follow-up interview studies were generally performed in 12～24 months after endovascular surgery. Results Ninety-one of 171 aneurysms were completely occluded, and 64 aneurysms were nearly competely occluded （≥95% occlusion） at embolization, 16 aneurysms had partial coiling （〈 95% occlusion）. Thirteen technical complication occurred at embolization, 1 patient was dead and 2 patients suffered from neurologic deficit. One patients rebleeded was found at 1 mouth after endovascular surgery. Forty-four patients with 48 aneurysms were selective angiography at 1 and 2 years after the treatment. In angiographic follow-up： 7 of the 48 aneurysms had been fund the recurrence, and 3 aneurysms with incomplete initial occlusions had been found the anatomic occlusion at 1 yeas after the treatment. Conclusion Early endovascular treatment of rupture cerebral aneurysms was a safe and effective method, and the recanalization was relate to the neck remnant of the aneurysm. The use of Matrix and Neuroform may improve anatomical outcomes by decreasing aneurysm recanalization.
出处
《广州医药》
2006年第3期10-14,共5页
Guangzhou Medical Journal
关键词
颅内动脉瘤
栓塞
随访
Intracranial aneurysms
Endovascular embolization
Follow-up
