前交通动脉瘤形态学特点与栓塞可行性关系

Relationship between morphology of anterior communicating artery aneurysms and feasibility of endovascular coil embolization

目的总结栓塞治疗前交通动脉瘤的经验体会,探讨其适应证、技术要点、形态学特点与栓塞可行性的关系及并发症的防治。方法回顾性分析栓塞治疗36例破裂前交通动脉瘤患者的临床资料、栓塞过程以及疗效。结果36例中成功栓塞34例,其中22例100%栓塞,5例95%栓塞,7例90%栓塞。术中动脉瘤破裂2例,1例死亡。5例出现严重血管痉挛。1例死于术后并发症。随访6～58个月,无术后再出血病例,3例复发。结论栓塞是治疗前交通动脉瘤的一种微创、相对安全有效的治疗方法。前交通动脉瘤形态学特点是治疗前评估血管内栓塞是否成功的重要依据。

Objective To summarize the experience of endovascular treatment for anterior communicating artery （AcoA） aneurysms and discuss the indications of the embolization, the aneurysm morphology and its relationship to the feasibility of endovascular coil embolization, the technical points of procedure and complications. Methods The clinical data of 36 cases with ruptured AcoA aneurysms treated by endovascular embolization were retrospectively reviewed. Results 34 of 36 cases were embolized successfully. Complete embolization was achieved in 22, 5 aneurysms were 95% embolized, and 7 aneurysms 90% embolized. Rupture during embolization occurred in 2 patients and 1 died. Severe vasospasm occurred in 5. One patient died of complications following embolization. No rebleeding was found post embolization during a follow up from 6 to 58 months and 3 recurred. Conclusions Endovascular embolization is a minimally invasive, relatively safe and effective method for treatment of AcoA aneurysm. Aneurysm morphology should be considered to assess the probability of successful endovascular treatment for AcoA aneurysm.