血管内治疗后部循环脑动脉瘤(附30例报告

Endovascular treatment of posterior cerebral artery aneurysms with 30 cases reports

目的通过对30例后循环脑动脉瘤探讨、分析血管内治疗的优势和不足之处。方法采用Seldinger法经股动脉穿刺插管,选择适宜微导管与GDC铂金微弹簧圈行栓塞术。结果痊愈23例,恢复良好3例,恢复差2例,死亡2例(1例为术后再出血凶猛,失去了抢救时机,1例为脑干受压严重,神经细胞发生不可逆改变)。结论血管内栓塞治疗后循环脑动脉瘤不能完全取代开颅显微直视下的动脉瘤夹闭术,但可作为不能接受外科手术治疗的最佳选择,而且具有创伤小、手术风险明显减少、成功率高,疗效肯定等优势。

Objective To explore the the advantages and disadvantages of endovascular treatment of posterior cerebral artery aneurysrss. Method 30 cases underwent endovasculac treatment , as Seldinger procedure was used and by minute tube and platinum microcoil through femoral artery, suitable tiny vessel was selected and GDC received embolization. Results As a result of this treatment, 23 patients recovered out of 30, among the rest 7 , 3 patients were really well cured, 2 didn＇ t get good recovery , and 2 patients died. One of the deaths was causext by too massive bleeding to be salvaged after operation. The other was due to none reversible damage to never cells due to serious brain stem compression. Condusiollts Endovascular embolization for Posterior cerebral artery aneurysms can＇ t replace clipping and ligation of aneurysm, but can be an optimized choice when the patients can＇ t afford surgical operations with its advantages of being minimally invasive, less operation risks , high successful rate and confirmed therapeutic effects .