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目的总结以电解可脱性弹簧圈(GDC)血管内栓塞治疗颅内动脉瘤的技术要点、并发症及其防治经验。方法采用GDC对168例颅内动脉瘤患者进行动脉瘤囊内栓塞。结果成功栓塞168个动脉瘤,其中100%闭塞的144个,95%闭塞的14个,90%闭塞的10个;全组6例死亡,死亡率3.6%。术中并发动脉瘤破裂3例,脑血管痉挛9例,脑梗死2例,术后弹簧圈末端逸出2例;3例复发者经二次补充GDC栓塞而治愈。随访5~54个月,全组术后均无再出血。结论动脉瘤的血管内治疗应根据病情进行个体化设计,并采用与之相应的栓塞技术才能最大限度的提高动脉瘤栓塞的治愈率、降低并发症。
Objective To summarize the technical points, complications and prevention and treatment of intracranial aneurysms treated with endovascular embolization of detachable coils (GDC). Methods A total of 168 patients with intracranial aneurysms were treated with GDC. Results A total of 168 aneurysms were successfully embolized, including 144 with 100% occlusion, 14 with 95% occlusion and 10 with 90% occlusion. All 6 patients died with a mortality rate of 3.6%. 3 cases of intracranial aneurysm rupture, 9 cases of cerebral vasospasm, 2 cases of cerebral infarction, 2 cases of esophageal varices escaped after surgery; 3 cases of relapse were treated by secondary replenishment of GDC embolization. All the patients were followed up for 5 to 54 months. No recurrence was found in the whole group. Conclusion Endovascular treatment of aneurysms should be individually designed according to the condition and the corresponding embolization technique can be used to maximize the cure rate of aneurysm embolization and reduce the complications.