电解可脱性弹簧圈血管内栓塞颅内动脉瘤的技术及并发症防治

The technique and the prevention of complications of intracranial aneurysms by using the GDC endovascular embolization

目的 总结以电解可脱性弹簧圈（GDC）血管内栓塞治疗颅内动脉瘤的技术要点、并发症及其防治经验。方法 采用GDC对168例颅内动脉瘤患者进行动脉瘤囊内栓塞。结果成功栓塞168个动脉瘤，其中l00％闭塞的144个，95％闭塞的14个，90％闭塞的10个，全组6例死亡，死亡率3．6％。术中并发动脉瘤破裂3例，脑血管痉挛9例，脑梗死2例，术后弹簧圈末端逸出2例，3例复发者经二次补充GDC栓塞而治愈。随访5～54个月，全组术后均无再出血。结论 动脉瘤的血管内治疗应根据病情进行个体化设计，并采用与之相应的栓塞技术才能最大限度的提高动脉瘤栓塞的治愈率、降低并发症。

Objective We summarized the technical main points the complications and the prevention and curative experiences of healing the intracranial aneurysms by using the Guglielmi detachable coil （GDC） endovascular embolization. Methods Using the GDC to aneurysmal intracapsular emholization in 168 cases of aneurysms patients. Results One hundred and sixty-eight cases of aneurysms were successfully emholized, among them, 144 cases were 100% occluded, 14 cases were 95% occluded, and 10 case were 90% occluded, 6 cases were died in the whole group. The mortality rate was 3.6%. There were 3 cases complicated with aneurysm rupturing, 9 cases complicated with cerebral vasospasm, and 2 cases complicated with cerebral infarction in operation; 2 cases were affected by mieroeoil terminal escaped in postoperation; 3 recurrent cases were cured by secondary complementary GDC emholizing. In the whole group none was rebleeding in postoperation with follow-up visiting from 5 to 54 months. Conclusion During the endovascular therapy of aneurysms , we should design individulizationally by patients pathogenetic condition, and use the adaptive embolismic technique. Only had perfect neurosurgical technique, strict normative operation and affluent experience of aneurysmal embolization, should we utmostly increase the healing rate of aneurysmal emholization and decline the complications.