血管内栓塞治疗颅内动脉瘤的并发症及疗效分析

The complications and the curative effect of endovascular embolization in intracranial aneurysm.

目的探讨颅内动脉瘤血管内栓塞治疗的并发症发生原因及防治措施,并分析该治疗方法的疗效。方法应用微导管技术,在数字减影血管造影(DSA)监视下,对80例颅内动脉瘤用可控弹簧圈行血管内治疗,对其并发症及随访结果进行分析。结果术中动脉瘤破裂5例,弹簧圈脱出至载瘤动脉5例,术中引起严重脑血管痉挛7例,载瘤动脉或邻近动脉闭塞2例,脑梗死2例,因并发症死亡6例;60例术后不同时期随访,无变化者50例,材料压缩6例,再通4例。结论随着栓塞技术的改进和材料质量的提高可以降低各种并发症的发生,弹簧圈栓塞疗效肯定;术后定期随访是必要的,尤其对部分栓塞者。

Objective To explore the causes of complications in the endovascular embolization of intracranial aneurysm,the prevention and treatment and the curative effect of the endovascular embolization. Methods 80 cases of intracranial aneurysm were treated with endovascular therapy by using the micro-catheter technology and the coils with the inspecting of DSA. The complications and the results of following up were analyzed. Results 5 cases had intraoperative aneurismal rapture; In 5 cases the coil escaped from the aneurysm into the parent artery; 7 cases had seriously intraoperative cerebral vasospasm ; 2 cases had obstruction in the parent artery and the nearby arteries ; 2 cases had cerebral infarction; 6 cases died of the complications. Of 60 cases which were followed up in different period after operation,50 were unchanged; 6 cases had materials compression; 4 cases reopened. Conclusion The embolization technique and the improvement of embolization materials could reduce all kinds of complications. The embolization therapy using with coil has good curative effect. It is necessary by following up regularly especially for the patients with partial embolization.