颅内动脉瘤的联合栓塞治疗

Combined embolization of the cerebral aneurysm with guglielmi detachable coils

目的探讨应用电解可脱卸弹簧圈（GDC）栓塞治疗颅内动脉瘤的临床效果．方法2002年6月～2004年6月我们采用电解可脱弹簧圈（GDC）栓塞颅内动脉瘤126例（其中4例有2个动脉瘤，共130个）．前交通动脉瘤42个，后交通动脉瘤53个，颈内动脉瘤6个，大脑中动咏瘤10个，大脑后动脉瘤8个，大脑前动脉瘤6个，小脑后下动脉瘤2个；基底动脉瘤3个。按Hunt-Hess分级：Ⅰ级38例，Ⅱ级54例，Ⅲ级23例，Ⅳ级11例。必要时辅以篮筐技术、重塑技术、支架技术、双微导管或连环技术、蚕食技术。结果成功栓塞126例动脉瘤，其中103例为100％栓塞，21例为95％，2例为90％。12例在栓塞后6～18个月进行造影随访，所栓塞动脉瘤均未见复发征象。结论GDC栓塞颅内动脉瘤是安全、有效和微创的治疗手段。联合运用多种栓塞技术有助于减少术后并发症，提高治愈率。

Objective To evaluate the effect of the endovascular embolization with （,uglielmi detachable coils（GDC） in 126 patients with cerebral aneurysm. Methods One hundred and twenty -six cases（ 130 aneurysms） of intracranial aneurysm were embolized with GDC（ Guglielmi detachable coil） ,combined basket technique, remodeling technique（RT）, stent technique, double micro- catheter technique or hand in hand technique and piecemeal technique if necessary,from June 2002 to June 2004. Four cases were found to have 2 aneurysms. The locations of aneurysms were as following： 42 cases in anterior communicating artery , 53 cases in posterior communicating artery , 6 cases in internal carotid artery, 10 cases in middle cerebral artery, 8 cases in posterior cerebral artery, 6 cases in anterior cerebral artery, 2 cases in posterior inferior cerebellar artery, 3 eases in basilar artery . HESS - HUNT grade was as following ： 38 cases of grade Ⅰ, 54 cases of grade Ⅱ, 23 cases of grade Ⅲ, 11 case of grade Ⅳ. Results 100% occlusion was achieved in 103 cases, 95% in 21 and 90% in 2 . In a period of 6 -18 months following- up in 12 cases, patients reoccurred symptoms. Conclusion Endovascular embolization with GDC for the treatment of cerebral aneurysm is a safe, effective and micro - traumatic method. Several techniques combined will decrease the complications and improve filture outcomes.