Matrix弹簧圈栓塞治疗颅内破裂动脉瘤的并发症

Perioperative Complications Associated with Endovascular Embolization of Ruptured Intracranial Aneurysms with Matrix Coils

目的评价Matrix弹簧圈栓塞颅内破裂动脉瘤的安全性。方法回顾性分析应用Matrix弹簧圈栓塞的102枚颅内破裂动脉瘤的临床表现、影像学资料、治疗过程、并发症和临床结果,分析与治疗相关并发症的发生、类型、频率、相关因素和后果。结果发生并发症的有16例,其中术中动脉瘤破裂9例,血栓形成3例,弹簧圈脱出1例,载瘤动脉闭塞3例,并发症发生率为15.69%。6例患者无神经功能异常,3例患者具有暂时性神经功能异常,6例患者具有持久性神经功能障碍,1例患者死亡。与治疗相关性持久性神经功能障碍发生率和死亡率分别为5.88%和0.98%。结论应用Matrix弹簧圈栓塞颅内破裂动脉瘤和应用裸金属圈栓塞一样安全,生物活性物质不增加血栓形成的风险,但应用Matix弹簧圈栓塞远段、较小动脉瘤应慎重。

Objective To evaluate the safety of embolization of ruptured intracranial aneurysms with matrix coils. Methods From October 2003 to September 2005, a total of 102 patients with 102 ruptured aneurysms and 10 unruptured aneurysms underwent embolizations with matrix coils. Their clinical data including clinical manifestations, imaging examination, endovascular procedures, curative effect and complications were analyzed retrospectively. Results The complications （15.69%） occurriong in 16 patients included intraoperative rupture of aneurysms in 9 patients （8.82%）, thrombosis in 3 （2.94%）, coil migration in 1 （0.98%） and occlusions of the parent arteries in 3 （2.94%）. Of 16 patients with complications, 6 had no neurological disturbance, 3 transient neurological deficits, 6 persistent neurological deficits and 1 died. The rates of endovascular procedure-related persistent neurological deficits and mortality were 5.88% and 0.98% respectively. Conclusions The endovascular treatment of ruptured intracranial aneurysms with matrix coils is as safe as that with bare platinum coils. Matrix coil does not increase the risk of thrombosis. We must be especially care when embolizing small less than 5 mm in diameter and distal aneurysms with matrix coils.