球囊辅助技术在颅内宽颈动脉瘤介入栓塞中的应用

Treatment of wide-necked cerebral aneurysms using balloon-assisted technique

目的探讨球囊辅助技术在颅内宽颈动脉瘤栓塞治疗的应用体会。方法采用球囊辅助瘤颈成形术对34例患者36个颅内宽颈动脉瘤进行栓塞治疗。29例患者发生蛛网膜下腔出血。其中19个动脉瘤发生在颈内动脉,10个动脉瘤发生在椎基底动脉,7个动脉瘤发生在其他小动脉。球囊辅助技术采用双导管,微导管送入动脉瘤内后,不可脱球囊置于瘤颈,充盈以覆盖瘤颈,再行GDC填塞动脉瘤。结果球囊辅助栓塞完全35个,次全填塞1个,无死亡,轻度神经功能障碍1例。平均随访(5.3±1.2)个月,球囊辅助栓塞再通率12.5%(1/8)。结论球囊辅助技术是处理颅内宽颈动脉瘤安全、有效的方法。采用球囊保护技术栓塞动脉瘤的效果优于单纯采用弹簧圈栓塞的效果,并且球囊保护技术复杂程度较低。

Objective To discuss the avail of balloon-assisted in treatment of wide-necked cerebral aneurysms. Methods Thirty-six aneurysms in 34 patients were selected for treatment with the ＂remodeling technique＂ （RT）. Twenty-nine of the patients presented with subarachnoid hemorrhage. Nineteen at the internal carotid artery, 10 of the aneurysms were located at the vertebrobasilar artery, and seven at the level of smaller arteries. Two catheters were used in balloon-remodeling technique, balloon were inflated across the neck of the aneurysms after the microcatheter entering the aneurysms, then the GDC were used to embolize the aneurysrns. Results Thirty-five aneurysms were completely occluded and 1 incompletely occluded using balloon-assisted technique, 1 patients with mild neurological dysfunction and no mortality. Partial patients had （5. 3±1.2） months follow-up. Rates of recanalization were 12.5%（1/8） for balloon-remodeling group. Conclusion The balloon- assisted remodeling technique were safe and effective in treatment of wide-necked aneurysms. The results of occlusion with the RT seem better than those in our series of normal GDC treatment, and complications related to the technique are fewer.