颅内动脉瘤血管内治疗辅助方法的应用

Application of the Assisted Therapies of Embolizing the Cerebral Aneurysms with Coils or Onyx

目的:探讨辅助方法在颅内动脉瘤血管内治疗中应用的指征和意义。方法:回顾性分析805例颅内动脉瘤患者的临床资料,其中应用血管内治疗辅助方法97例。分析颅内动脉瘤血管内治疗中所应用的辅助方法并分类、归纳。结果:辅助技术应用的比率为12.05%,成功率为96%;因辅助技术应用直接导致死亡2例;术中使用辅助技术时继发血栓形成2例。结论:颅内动脉瘤血管内治疗辅助方法主要应用于宽颈囊性动脉瘤、夹层动脉瘤、假性动脉瘤、梭形动脉瘤、终末支动脉瘤、大型或巨大型动脉瘤和形态不规则动脉瘤等,可分为:①暂时性动脉瘤颈辅助技术;②永久性动脉瘤辅助技术;③间接辅助技术。辅助技术适当应用可以:①防止并发症的发生;②将部分不能直接使用弹簧圈栓塞的动脉瘤进行栓塞治疗;③取得更加致密的栓塞效果;④提高远期疗效等。

Aim： To summarize and classify the assisted therapies for treating cerebral aneurysm with coils or Onyx. To detect the indications and significance of the assisted therapies in the clinical procedure. Methods： 805 cases suffered form cerebral aneurysms were analysed retrospectively. 97 cases were treated with endovascular therapy combining with an assisted therapies. The assisted therapies used include ①undetachable balloon remodeling, ② stent using, ③ BOT, ④ microwire remodeling, ⑤ micro-catheter remodeling, ⑥ ECIC Bypass. Results： The rate of the assisted therapies is 12.05%（97/805）. 2 patients were died due to the complication of the assisted therapies. Conclusion： The assisted therapies for the cerebral aneurysms can be classified as follow temporary assisted therapies, permanent assisted therapies and indirectly assisted therapies. A good clinical result will be got if the assisted therapies are used reasonably.