微弹簧圈栓塞治疗脑动脉瘤临床应用效果探讨

Clinical Value of Endovascular Coiling on Intracranial Aneurysms

目的通过126例脑动脉瘤微弹簧圈栓塞治疗结果分析,探讨微弹簧圈栓塞治疗脑动脉瘤的临床应用价值。方法2004年10月-2007年2月,我院对195例经脑CT或MRI检查,对发现珠网膜下腔出血或疑为脑动脉瘤的患者行全脑血管造影(DSA)检查,其中88例采用旋转血管造影(R-DSA)和三维血管重建技术(3D-DSA)检查,126例证实为脑动脉瘤患者。126例患者在全麻下行脑动脉瘤微弹簧圈栓塞治疗。结果126例脑动脉瘤,123例成功栓塞,成功率达97.6%;失败3例,占2.4%;栓塞过程中动脉瘤破裂7例,占5.6%,破裂的脑动脉瘤均继续行栓塞并治疗成功;动脉瘤栓塞术后造成轻偏瘫3例,占2.4%;死亡2例,占1.3%。结论脑动脉瘤介入栓塞治疗成功率高,术后并发症少,是一种安全、有效的治疗方法。

Objective To assess the initial treatment results of endovascular embolization of 126 patients with cerebral aneurysms,and evaluate clinical value of endovascular treatment for intracranial aneurysms. Methods From Octomber 2004 to Febuary 2007,cerebral angiography was performed in 195 patients with subarachnoid hemorrhage or suspected cerebral aneurysms on CT or MRI scan. 88 of these patients underwent R -DSA and 3D -DSA, and 126 cases were identified to cerebral aneurysms on DSA findings, and 126 cases with intracranial aneurysms were treated with detachable coils under general anaesthesia. Results Endovascular embolization was successfully performed in 123 patients. Technical success rate reached 97.6% , and technical failure rate 2. 4% that occurred in 3 patients. The rupture of aneurysms occurred in seven patients （5.6% of 126 patients） during the endovascular embolization,but all 7 patients were further embolized after bleeding; 3 cases slightly paralysed and 2 cases died resulting from the embolization operation, so the procedure -related morbidity and mortality were respectively 2. 4% and 1.3%. Conclusion Endovascular embolization of intracranial aneurysms is a safety and effective treatment with high incidence of technical success and low incidence of complications.