电解铂金微弹簧圈栓塞治疗颅内动脉瘤中并发症原因及防治

Prevention and management of the complications during embolization of intracranial aneurysm with GDC

目的 探讨电解铂金弹簧圈 (GDC)栓塞治疗颅内囊状动脉瘤术中并发症及防治。方法 对 16 2例患者 171枚颅内动脉瘤栓塞中出现 9例并发症 ,其中 5例动脉瘤破裂出血 ,立即中和肝素继续栓塞 ,2例GDC脱出动脉瘤立即手术取出 ,动脉瘤夹闭 ,2例血栓形成 ,术中溶栓 ,术后均采用腰穿置管持续引流 ,解痉及对症处理。结果 5例恢复良好 ,2例永久性轻度功能障碍 ,2例死亡。结论 GDC栓塞颅内动脉瘤术中发生并发症与手术操作 。

Objective To discuss embolization of intracranial aneurysm with Guglielmi detachable coil (GDC), to prevent and manage the complications during the endovascular treatment.Methods One hundred and sixty two patients with 171 intracranial aneurysms were embolized by using GDC. Nine complication cases included 5 aneurysm rupture during the procedure with immediate neutralizing the haparin and continuously embolizing until the bleeding stop, 2 cases of GDC end protruding out of the aneurysms curred by stoppage clipping and 2 cases of thrombosis curred with continuous thrombolysis. Lumbar subarachnoid drainge with antispastic and other supporting measures were taken in all cases after the procedure. Results All 9 cases included 5 recovering uneventfully, 2 only suffering from mild deficit. Another 2 cases were dead.Conclusion Complications during procedure of intracranial aneurysm embolization with GDC may be related to the manipulation conditions of the parent artery and aneurysm.