89例颅内动脉瘤栓塞术后血管造影随访报告

Angiographic follow-up of 89 intracranial aneurysms after endovascular treatment

目的评估脑动脉瘤栓塞术后的稳定性。方法共血管内栓塞100例动脉瘤,对其中89例于栓塞术后至少3个月进行脑血管造影复查。结果70例动脉瘤完全栓塞,15例动脉瘤次全栓塞,4例动脉瘤不全栓塞。70例完全栓塞动脉瘤中7例（10%）在3个月到3年时间内复发。4例行二次栓塞手术。2例动脉瘤有小的瘤颈残留,虽有增大,但无须特殊处理。1例动脉瘤瘤颈残留稳定。15例次全栓塞动脉瘤中5例瘤颈残留继续增大,3例行二次手术。4例不全栓塞中3例复发。所有病例均无再破裂出血。结论尽管动脉瘤完全栓塞,长期造影随访结果显示动脉瘤颈可以有小的复发。动脉瘤复发与动脉瘤栓塞程度、大小、位置、体颈比例有关。

Objective To evaluate the stability of aneurysm occlusion at follow-up angiography after endovascular treatment （EVT） with detachable coils in intracranial aneurysms. Methods A total of 100 aneurysms were treated with EVT. Follow-up angiography at least 3 months later was performed in 89 cases. Results Complete occlusion of the aneurysm sac and neck was achieved in 70 aneurysms, subtotal occlusion in 15, and incomplete occlusion in 4. Recurrence occurred between 3 and 36 months in 7 （ 10% ） of the 70 totally occluded aneurysms. A second treatment was performed in four cases, The small neck remnant increased in size but did not require any retreatment in two cases, and the size of the neck remnant remained stable in 1 cases. Remnant regeneration occurred in 5 of the 15 subtotally occluded aneurysms. A second treatment was performed in three. No rebleeding occurred. Conclusion A very small recurrence may be observed at the level of the neck of the aneurysm at long-term follow-up angiography despite achieving total occlusion initially with detachable coils. The recurrence of aneurysm is correlated to the degree of occlusion, location,size and ratio between sac and neck.