颅内动脉瘤血管内载瘤动脉闭塞治疗的临床效果(附23例长期随访报告)

Parent artery embolization treatment of intracranial aneurysms (a long-term follow up reports of 23 cases)

目的 探讨以可脱性球囊闭塞载瘤动脉治疗颅内动脉瘤的技术要点、远期疗效及应用价值。方法 对 2 4例颅内动脉瘤行可脱性球囊闭塞载瘤动脉术 ,其中 19例第 1枚球囊同时闭塞了动脉瘤口。结果 2 4例中 2 1例病情恢复良好 ,无并发症 ;全组术后并发脑缺血和脑梗死 3例 ,其中 1例死亡 ;术中及术后均无动脉瘤破裂出血。结论 以可脱性球囊闭塞载瘤动脉是治疗某些不可手术夹闭或因故不能行瘤腔栓塞的颅内动脉瘤的有效方法 ;但闭塞载瘤动脉后有可能导致脑缺血及其他并发症 ,故应严格掌握适应证。

Objective To discuss the indications, technical points and long term effects of parent artery embolization of intracranial aneurysm with detachable balloon, and to get further evaluation of its practical value. Methods Monitored by DSA, parent artery embolization with detachable balloon was performed in 24 patients with intracranial aneurysms. 19 cases in all, the mouth of each artery aneurysm was also blocked with the first balloon. Results Parent arteries all had been successfully blocked in 24 cases. Good recovery without any complication was obtained in 21 cases, while complicated cerebral ischemia and infarction were found in 3 cases during post operation (1 case dead). No aneurysm re bleeding occured during the operation and post operation. Conclusion Parent artery embolization with detachable balloon is an effective method for treating intracranial aneurysm to such cases, in which surgical clip can not be done, or is not appropriate to be done by aneurysm embolization inside of the vesicles. However, the indication must be grasped rigorously, because complications may occur after operation.