前交通动脉瘤介入治疗分析

Interventional treatment for anterior communicating aneurysms.

目的探讨前交通动脉瘤的介入治疗适应证，手术方法和疗效。方法回顾性分析行血管内介入治疗的前交通动脉瘤63例患者的临床资料，分析术前影像学检查结果及手术方式和术后随诊结果。结果54例为责任动脉瘤破裂出血，另外9例为其他部位动脉瘤破裂出血而行DSA检查发现的前交通动脉瘤或者因其他原因行DSA检查发现的前交通动脉瘤。63例患者应用电解脱或者压力解脱铂金弹簧圈，利用微导管辅助3例，球囊辅助6例，支架辅助3例；57例动脉瘤完全闭塞，6例少量瘤颈残留；13例术后行脑室外引流；死亡2例。结论血管内治疗前交通动脉瘤是一种安全、微创、有效的方法，但前交通动脉瘤患者术后容易合并电解质紊乱以及脑积水等合并症，应注意合并症的处理。

Objective To discuss the indications,method and efficacy of endovascular embolization for anterior communicating aneurysms. Methods The clinical data of 63 cases of anterior communicating aneurysms treated with endovascular embolization were retrospectively analyzed. Results 54 cases had duty-anteriors communicating aneurysms which ruptured to result in subarachnoid hemorrhage （SAH）. The other 9 cases had other intracranial aneurysms which resulted in SAH or had DSA examination because of other causes,finding aneurysms. Guglielmi detachable coils （GDC） were used for endovascular embolization in all the cases. 3 cases had micro-catheter assist and 6 cases had balloon assist, another 3 cases had stent assist. 57 cases had complete obliteration and 6 had partly neck-residual. 13 cases had extra external ventricular drainages. There were 2 dead cases. Conclusion Interventional therapy is a minimally invasive, safe and effective method for treating the anterior communicating aneurysms, however, the patients are prone to complicate with electrolyte disturbance and hydrocephalus, so it is essential to treat the complications.