脑动脉瘤的介入栓塞治疗

Transluminal embolization of cerebral aneurysm

目的探讨血管内介入栓塞治疗在脑动脉瘤治疗中的应用价值。方法2003年10月至2005年12月,我院对126例经全脑血管造影证实的脑动脉瘤患者行介入栓塞治疗(88例采用旋转血管造影和三维血管重建技术),栓塞材料采用GDC或DCS(铂金弹簧圈),其中28例宽瘤颈动脉瘤采用血管内球囊辅助技术(Remodeling techn ique)或血管内支架(Neuroform)置入后行介入栓塞治疗,介入手术均在全麻下进行。结果126例脑动脉瘤,123例成功栓塞,成功率达97.6%;失败3例,占2.4%;栓塞过程中动脉瘤破裂7例,占5.6%,破裂的脑动脉瘤均继续行栓塞并治疗成功;动脉瘤栓塞术后造成轻偏瘫3例,占2.4%;死亡2例,占1.3%。结论脑动脉瘤介入栓塞治疗成功率高,术后并发症少,是一种安全、有效的治疗方法。

Objective To evaluate the reliability of coil embolization for intracranial aneurysm treatment. Methods One hundred and twenty six patients diagnosed as intracranial aneurysms by cerebral angiography （rotate DSA and 3D re -construction performed in 88 cases ） underwent percutaneous transluminal embolization with GDC or DCS coils under general anesthesia, in which 28 cases who had wide - neck aneurysms took advantage of balloon remodeling technique or Neuroform stent placement. Results Coil embolization procedure were succeed in 123 cases with the technique success rate 97.6% , failure in other 3 cases （2.4%）.Operation related complications include 7 intraoperative aneurysm rupture （5.6%） , by which bleeding caused were controlled by subsequent embolization, mild hemiplegia 4 cases （2.4%）and death 2 cases （1.3%）. Conclusion Coil embolization seems to be a feasible and effective option for treatment of cerebral aneurysms with acceptable procedure related complications.