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目的探讨可脱性弹簧圈及可脱性球囊血管内栓塞治疗颅内动脉瘤的效果及技术要点。方法对1328例来自华南地区部分省市的颅内动脉瘤应用微导管技术,在数字减影血管造影监视下行血管内栓塞治疗,其中85例90个动脉瘤用机械式可脱性弹簧圈(MDS)栓塞,825例847个动脉瘤用电解式可脱性弹簧圈(GDC)栓塞。67例巨大动脉瘤中37例用可脱性球囊闭塞载瘤动脉,18例用GDC,11例用EDC,1例用MDS闭塞载瘤动脉。结果成功栓塞1328例1370个动脉瘤,1322例痊愈,6例死亡。栓塞程度:100%栓塞1281个(包括载瘤动脉闭塞者),95%栓塞65个,90%栓塞20个,80%栓塞4个。术中动脉瘤破裂9例,并发脑梗死5例,1例微弹簧末端逸出并顽固性脑血管痉挛。2例复发者再给予GDC栓塞而治愈。结论血管内栓塞治疗颅内动脉瘤是一种比较安全、可靠、有效的治疗手段,动脉瘤较大者,术后复发率高;术前反复蛛网膜下腔出血者,术中动脉瘤破裂的可能性较大。
Objective To investigate the effect and technical points of treatment of intracranial aneurysms with detachable coil and detachable balloon endovascular embolization. Methods A total of 1328 intracranial aneurysms from some provinces and cities of southern China were treated with micro-catheter technique and endovascular embolization with digital subtraction angiography. Among them, 85 aneurysms of 90 patients were treated with mechanical detachable coil ) Embolization, and 825 847 aneurysms were occluded with an electrolytically releasable coil (GDC). Thirty-seven of 67 giant aneurysms occluded the parent artery with detachable balloons, 18 with GDC, 11 with EDC, and 1 with MDS to occlude the parent artery. Results 1328 aneurysms were successfully embolized in 1328 patients, 1322 recovered, and 6 died. Degree of embolism: 128% occlusion of 100% (including tumor-bearing artery occlusion), 95% embolization of 65, 90% embolization 20, 80% embolization 4. Intraoperative aneurysm rupture in 9 cases, complicated by cerebral infarction in 5 cases, 1 case of spring tip escape and intractable cerebral vasospasm. 2 cases of relapse were given GDC embolization and cure. Conclusions Endovascular embolization is a safe, reliable and effective treatment for intracranial aneurysms. The larger the aneurysm, the higher the recurrence rate after surgery. The patients with repeated subarachnoid hemorrhage and intraoperative aneurysm rupture More likely.