颅内大型动脉瘤的血管内治疗及随访

Intracranial Large Aneurysms: Endovascular Treatment and Following-up (a Report of 109 Cases)

目的探讨血管内治疗大型动脉瘤的方法、效果及其并发症的防治。方法回顾性分析2000年1月至2006年12月间我科经血管内治疗的109例颅内大型动脉瘤患者的临床资料。结果患者术后恢复良好99例(90.8%),功能障碍8例(7.3%),死亡2例(1.8%)。101例(共105枚)大型动脉瘤患者接受血管内栓塞治疗,其中100%闭塞73枚,90%～95%闭塞21枚,80%闭塞11枚。8例患者行载瘤动脉闭塞术。107例术后随访8～36个月无出血病例。58例患者经血管造影或MRA随访,9枚动脉瘤再通。结论血管内栓塞治疗颅内大型动脉瘤安全、有效,中期疗效肯定,长期随访结果尚待进一步完善。

Objective To explore the technique of endovascular treatment of intracranial large aneurysms and its curative effect on them. Methods The clinical data of 109 patients with intracranial large aneurysms who underwent endovascular treatment from January, 2000 to December, 2006 were analyzed retrospectively. All the patients, except 2 patients, were followed up from 8 to 36 months. Results Of 109 patients, 99 （90.8%） received good recovery, 8 （7.3%） poor recovery, and 2 （1.8%） died. In 101 patients with 105 large aneurysms treated by endovascular embolization, the lumina of 73 aneurysms were embolized by 100%, 21 by 90%-95%, and 11 by 80%. The aneurysms in 8 patients were treated by occlusion of the parent arteries. Rebleeding did not occur during the following-up in 107 patients receiving following-up. DSA or MRA examination in 58 patients showed that 9 aneurysms were recanalized during following-up. Conclusion Endovascular embolization is a safe and effective method to treat intracranial large aneurysms.