血管内栓塞治疗颅内动脉瘤及其并发症的防治

Endovascular embolization in managing intracranial aneurysms and prevention and cure for its complications

目的着重讨论微弹簧圈栓塞治疗颅内动脉瘤的方法、技术和手术相关并发症及其防治.方法回顾总结血管内栓塞治疗颅内动脉瘤88例病人,90个动脉瘤.结果100%闭塞70例、90%～95%闭塞13例、80%闭塞5例.术后手术相关并发症9例:微弹簧圈移位3例,术中动脉瘤破裂4例,严重血管痉挛2例;其中死亡2例.结论血管内栓塞动脉瘤腔是一种微创、安全、有效治疗动脉瘤的方法.选择正确的技术和方法对改善动脉瘤栓塞治疗效果,减少并发症有重要意义.

Objective To discuss the techniques and the prevention and cure of preoperative complications of the endovascular embolization in managing the intracranial aneurysms. Methods A total of 90 aneurysms in 88 patients were treated by detachable coils embolization. The clinical results and the management of complications were reported. Results Seventy aneurysms were occluded at 100%, 13 aneurysms at 90% to 95% and 5 aneurysms at only 80. The perioperative complications occurred in 9 patients, including the coil escaping from the aneurysm sac into its parent artery in 3 patients, re-rupturing of aneurysm in 4 patients during operation and serious vasospasm in 2 patients. Two patients died. Conclusion The endovascular embolization is a safe, effective and micro invasive method in managing intracranial aneurysms. The exact embolizing techniques chosen are very important to improve the curative results and decrease the complications of embolization of intracranial aneurysms.