电解可脱性弹簧圈栓塞治疗大脑后交通动脉瘤

Endovascular treatment of intracranial posterior communicating artery aneurysm with Guglielmi detachable coil

目的 讨论以电解可脱性弹簧圈血管内栓塞治疗后交通动脉瘤的疗效及技术要点。方法 对 42例后交通动脉瘤患者用电解可脱性弹簧圈进行动脉瘤囊内栓塞 ,术后早期处理出血。结果 42个动脉瘤中 3 8个瘤腔完全闭塞 ,3个95 %闭塞 ,1个被 90 %闭塞。术后 41例临床痊愈 ,1例死亡 ,死亡率 2 .4%。术中并发脑血管痉挛 1例 ;术后弹簧圈末端逸出 1例。 1例复发者经二次补充GDC栓塞而治愈。全组出现与栓塞技术相关的并发症 2例。术后随访 3～ 5 0个月均无再出血。结论 对后交通动脉瘤采用电解可脱性弹簧圈进行血管内囊内栓塞疗效可靠 ;

Objective To discuss the techniques and managements of complications in endovascular embolization on posterior communicating artery aneurysm (PComAA) with Guglielmi detachable coils (GDC), and to evaluate the effect of treatment. Methods A total of 42 cases with PComAA were treated with GDC to embolize the aneurismal sac via femoral artery approach. Early intervention of hemorrhage was performed post-operation. Results All 42 patients were cured, in which 41 cases recovered clinically, 1 patient died. The mortality was 2.4%. The sac of 38 aneurysms were achieved 100% embolization, 3 with 95% embolization, 1 with 90% embolization. Aneurysms had not repunctured during the embolization. 1 case happened cerebral vasospasm. 1 case microcoil escaped. One recurring cases cured by second GDC embolization. The technique-related complications were present in 2 cases. No re-bleeding occurred in the 3-50 months follow-up. Conclusion GDC occlusion is a safe and effective treatment for the PComAA. Advances in the techniques and treating the complications correctly will decrease the complications and improve future outcomes.