Matrix可脱弹簧圈栓塞治疗颅内动脉瘤

Endovascular treatment intracranial aneurysm with Matrix detachable coil

目的 探讨Matrix可脱弹簧圈血管内栓塞治疗颅内动脉瘤的临床价值。方法 对 5 1例共 5 6枚颅内动脉瘤施行血管内Matrix可脱弹簧圈栓塞治疗 ,5 1例患者按Hunt Hess分级 :Ⅰ级 15例、Ⅱ级 2 4例、Ⅲ级 8例、Ⅳ级 4例 ,所有病例均经CT扫描和DSA造影诊断。 4例宽颈动脉瘤和 2例梭形动脉瘤采用Neuroform支架结合Matrix可脱弹簧圈栓塞治疗。结果 应用Matrix可脱弹簧圈栓塞成功 4 8例 5 3枚动脉瘤 ,占 94 .3% ;3例因严重血管痉挛导致微导管无法到位而实施动脉瘤夹闭术 ;1例弹簧圈尾端残留于载瘤动脉 ,但未导致临床后果 ;无死亡及严重并发症 ;4 8例随访 3～ 12个月无再次出血和并发症。结论 Matrix可脱弹簧圈血管内能够有效栓塞颅内各部位动脉瘤 ,术中有明显的促进动脉瘤腔内形成血栓的作用 ,术后促进血管内皮细胞生长覆盖动脉瘤颈口的作用。可以防止再次破裂出血。

Objective To explore the clinical value of endovascular embolization treatment with Matrix detachable coil for the patients with intracranial aneurysm. Methods 51 cases of patients with 56 intracranial aneurysms were undergone endovascular embolization treatment with Matrix detachable coil. According to Hunt-Hess classification, 15 belonged to gradeⅠ, 24 belonged to gradeⅡ, 8 belonged to grade Ⅲ, and 2 in grade Ⅳ. All the patients were diagnosed with DSA and CT scan. 4 cases of wide neck aneurysm were embolized with Neuroform stent supported by Matrix detachable coil. Results 48 cases with 50 intracranial aneurysms of 51 patients were succeed in endovascular embolization treatment with Matrix detachable coil. 3 cases were failed due to severe cerebrovascular spasm. The caudal of Matrix detachable coil protruded to the parent vessel in 1 case but had no clinical consequence. There were no complications and hemorrhage in the 48 cases in the follow-up 3 to 12 months. Conclusions Endovascular embolization treatment with Matrix detachable coil is an effective method for intracranial aneurysm to avoid hemorrhage.