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目的总结前交通动脉瘤栓塞治疗的经验。方法 2008年1月-2011年8月,23例前交通动脉瘤患者均在全身麻醉下行动脉瘤内栓塞治疗。其中4例在导丝或导管保护动脉瘤颈情况下行栓塞治疗;1例术中导丝刺破动脉瘤,继续快速填塞至动脉瘤完全栓塞;1例栓塞后弹簧圈突入载瘤动脉,行A1-A2段支架后置入。结果 23例患者手术技术成功率100%。术后即刻造影,动脉瘤完全栓塞11例,>90%栓塞8例,<90%栓塞4例。支架后置入患者术后出现脑梗死,经治疗1个月后康复出院。所有患者临床随访6～24个月,未见再出血。16例患者行全脑血管数字减影血管成像复查,动脉瘤未见复发,其中3例>90%栓塞、2例<90%栓塞患者动脉瘤完全闭塞。结论弹簧圈栓塞治疗前交通动脉瘤是一种安全、有效的治疗方式。但其技术难度相对较大,需要细致操作。
Objective To summarize the experience of the treatment of aneurysm embolism in anterior traffic. Methods From January 2008 to August 2011, 23 patients with anterior communicating aneurysms underwent aneurysm embolization under general anesthesia. 4 of them were treated by embolization in the circumstance of protecting the aneurysm neck with guide wire or catheter. One case of intraoperative guidewire pricked the aneurysm and continued to rapidly embolize it until the aneurysm was completely embolized. One case of the embolization coil protruded into the parent artery and A1 -A2 stent after the placement. Results The success rate of surgical technique in 23 patients was 100%. Immediate postoperative angiography, aneurysm complete embolization in 11 cases,> 90% embolization in 8 cases, <90% embolization in 4 cases. Intracranial infarction was inserted into the patient after stent implantation and was discharged after 1 month of treatment. All patients were followed up 6 to 24 months, no further bleeding. Sixteen patients underwent digital subtraction angiography of whole cerebrovascular disease. No recurrence of aneurysm was found. Among them, 3 patients had> 90% embolization and 2 patients <90% embolization had aneurysm complete occlusion. Conclusion Coil embolization is a safe and effective treatment for patients with traffic artery aneurysm. However, its technical difficulty is relatively large and requires careful operation.