血管内栓塞治疗颅内动脉瘤围手术期并发症

Perioperative Complications of Endovascular Treatment of Intracranial Aneurysms

目的总结血管内栓塞治疗颅内动脉瘤围手术期并发症,并讨论其防治方法。方法对184例血管内治疗的颅内动脉瘤患者的临床资料进行回顾性分析。结果36例患者在围手术期出现并发症,包括动脉瘤破裂出血6例,血管内栓塞6例,脑积水21例,其它并发症3例。其中死亡5例,肢体功能障碍2例。结论血管内栓塞、动脉瘤破裂出血和脑积水是颅内动脉瘤血管内治疗围手术期常见并发症,要积极防治,熟悉动脉瘤和载瘤动脉的解剖特点,掌握栓塞技巧和手术操作要求,早期引流蛛网膜下腔积血,有助于减少并发症的发生,提高患者治愈率。

Objective To analyze the perioperative complications of endovascular treatment of intracranial aneurysms and to explore the method to prevent and treat them. Method The clinical data of 184 patients with 201 intraeranial aneurysms treated by endovascular embolization were analyzed retrospectively. Results The perioperative complications occurred in 36 patients. The complications included the rupture of aneurysms in 6 patients, vascular abnormal embolization in 6, hydrocephalus in 21 and other complications in 3. Among 36 patients with perioperative complications, 5 died and 2 had hemiplegia. Conclusions The overall understanding of the aneurysm and its parent artery anatomy, and the skillful endovascular embolization technique are helpful to a decrease in the perioperative complications and an increase in the cure rate in the patients with intracranial aneurysms undergoing endovascular embolization. Early lumbar drainage of the bloody cerebrospinal fluid and the correct management of the complications can reduce disabled rate and mortality in the patients with intracranial aneurysms.