摘要
目的探讨介入栓塞治疗颅内破裂微小动脉瘤(直径≤3 mm)的疗效和技术要点。方法选取2013-01-2019-04济宁医学院附属医院35例颅内破裂微小动脉瘤行介入栓塞治疗的患者,采用3D-DSA选择工作角度测量动脉瘤大小(前后径、上下径、最大径、瘤颈和载瘤动脉的弯曲角度)。随访脑血管造影3~20个月(平均6个月)。结果对所有35个微小动脉瘤成功实施了弹簧圈栓塞,其中30例采用支架辅助弹簧圈栓塞,5例单纯弹簧圈栓塞。术中均未破裂出血,发生脑栓塞事件2例,术中弹簧圈不能完全填入1例。术后即刻造影示完全栓塞28个,次全栓塞5个,部分栓塞2个。术后半年复查造影,27例复查DSA,动脉瘤完全闭塞22例,不完全闭塞5例。结论介入栓塞是治疗颅内破裂微小动脉瘤有效手段,治疗关键是准确的术前评估和术中精细操作。
Objective To discuss thetechnical essential and efficacy with endovascular embolization forintracranial ruptured microaneurysms(DIA≤3 mm).Methods From Janurary 2013 to April 2019,35 patients with intracranial rupture microaneurysm in Jining Medical College were treated with interventional embolization,and 3 D-DSA was used to select the working angle to measure the size of the aneurysm(anterior and posterior diameter,upper and lower diameter,maximum diameter,tumor Carotid and tumor-bearing arteries).Follow-up of cerebral angiography was 3 to 20 months(mean 6 months).Results Endovascular embolization was successfully accomplished for all the 35 intracranial micro aneurysms.Stent-assisted technique was employed for 30 aneurysms.Simple Spring coil was employed for 5 aneurysms.During the procedure,bleeding due in 0 patients,cerebral embolism events in 2 patients,Spring coil was not implanted Completely in 1 patients.Cerebral angiography performed immediately after the treatment showed that complete occlusion of the aneurism was achieved in 28 aneurysms,subtotal occlusion in 5 aneurysms and incomplete occlusion in 2 aneurysms.DSA was conducted at 6 months after initial embolization in 27 patients.Angiographic findings showed that 22 aneurysms were completely occluded and 5 aneurysms were partially occluded.Conclusion For the treatment of tiny intracranial aneurysms endovascular embolization is clinically feasible and effective,Preoperative evaluation and the operation are crucial.
作者
许华
宋国红
XU Hua;SONG Guohong(Affiliated Hospital of Jining Medical College,Jining 272029,China)
出处
《中国实用神经疾病杂志》
2019年第22期2510-2514,共5页
Chinese Journal of Practical Nervous Diseases
