血管内治疗颅内巨大动脉瘤(附40例报告)

Endovascular treatment of intracranial giant aneurysms: report of 40 cases

目的探讨颅内巨大动脉瘤的血管内治疗方法,并对疗效进行评价。方法对40例颅内巨大动脉瘤行血管内治疗,其中33例行载瘤动脉闭塞术,5例行动脉瘤栓塞术,2例行颞浅-大脑中动脉搭桥术后闭塞载瘤动脉。结果载瘤动脉闭塞术后死亡3例,动脉瘤栓塞术后死亡1例,其余病人临床状况良好。临床随访28例,状况均良好;CT随访18例,示8例动脉瘤缩小或消失;造影随访15例,示9例动脉瘤不显影,3例瘤体缩小,2例载瘤动脉再通,1例栓塞后动脉瘤复发。结论对于手术困难的颅内巨大动脉瘤,血管内治疗是一种安全、有效的方法。

Objective To probe the endovascular treatment for intracranial giant aneurysms, and evaluate the therapeutic effect. Methods Forty cases of intracranial giant aneurysms treated by endovascular method were reviewed. Among them, 33 were treated by occlusion of parent artery, 5 by embolization of the aneurysm, 2 by occlusion of parent artery after STA-MCA bypass. Results Three patients died after the occlusion of parent artery, 1 died after the embolization of aneurysm, the others had good clinical situation. Twenty-eight patients with clinical following-up were in good status. Of the 18 patients with CT following-up, aneurysms were shrank or disappeared in 8. Of the 15 cases with DSA following-up, aneurysms disappeared in 9, shrank in 3, the parent artery recanalized in 2, and aneurysm recurred post embolization in 1. Conclusion Endovascular treatment is a safe and effective method for intracranial giant aneurysms which are hard to be cured by operation.