电解可脱性弹簧圈栓塞颅内动脉瘤的体会

Application of Guglielmi Detachable Coil Emboliza tion in Treatment of Intracranial Aneurysms

目的 评价电解可脱性弹簧圈栓塞 (GDC)治疗颅内动脉瘤的疗效并总结GDC的操作要点。方法 DSA检查 32例 ,发现颅内动脉瘤共 34枚 ,其中前交通动脉瘤 16枚 ,后交通动脉瘤 14枚 ,大脑中动脉动脉瘤 2枚 ,大脑后动脉 ,眼动脉各 1枚。随后用GDC进行栓塞治疗。结果 32例 (34枚 )颅内动脉瘤栓塞成功 ,其中完全致密栓塞 (瘤颈完全封闭 ) 2 0例 ,部分栓塞 (瘤体、瘤颈可见残余 ) 12例。并发动脉瘤破裂 1例 ,治疗后痊愈。并发脑血管痉挛 2例 ,治疗后 1例遗留轻偏瘫。术后 1年内随访 6例 7枚动脉瘤 ,无明显变化。结论 GDC栓塞治疗颅内动脉瘤是一种安全可靠、有效的治疗方法 ,术者的操作技术及对并发症的正常处理是影响手术成败的重要因素 ,对部分栓塞者有必要随访观察。

Objective To To evaluate the efficacy of Guglielmidetachable coil (GDC)F embolization in treatment of intracranial aneurysms and summarize the main points of GDC manipulation.Methods Thirty two patients were examined with digital substraction angiography (DSA) and 34 intracranial aneurysms were found, including 15 aneurysms in the anterior communication artery, 13 in the posterior communi cation artery, 2 in the middle cerebral a rtery, 1 in the anterior cerebral artery and 1 Ophthalmic artery. After wards GDC was used for embolization therapy. Results Thirty two patients with 34 aneurysms were successfully embolized with GDCs. Complete embolization achieved in 20 patients and incomplete in 12 patients; while one aneurysm ruptured during the performance, but all curedafter treatment. Vas cular spasm occurred in 2 patients, one of them had slight hemiplegia. Sixpatients with 7 aneurysms were followed up by DSA examinationl year after operation. No obvious change was observed.Conclusions Treatment of intracranial aneurysms with GDC embolization is a safe, reliable, and effective measure. Skillful techniques of the operator and correct management of complications are important factors affecting the outcome of operation. A period follow up is essential to patients with partial embolism.