颅内动脉瘤可解脱弹簧栓塞治疗——附28例分析

Embolization Therapy with Detachable Coils of Intracranial Aneurysms,Analysis of 28 Cases

目的:比较评价 MDS 和 GDC 栓塞颅内动脉瘤的疗效。材料和方法:28例颅内动脉瘤(宽颈动脉瘤6例,狭颈动脉瘤22例)患者接受了血管内治疗,其中 MDS 栓塞9例,GDC 栓塞19例。术后即时和6个月后作血管造影以评价其栓塞效果。结果:28例经血管治疗手术成功26例,失败2例。在用 MDS 栓塞成功的8例中,完全栓塞2例(25%),大部栓塞(栓塞范围>70%)3例(38%),部分栓塞(栓塞范围<70%)3例(38%)。在用 GDC 栓塞成功的18例中,完全栓塞12例(67%),大部栓塞4例(22%),部份栓塞2例(11%)。术后6个月随访血管造影7例,无1例显示动脉瘤再开放。术后血栓形成发生2例,1例2周后完全恢复,另1例留有永久后遗症。1例手术失败,因动脉瘤再次破裂1周后死亡。结论:在狭颈动脉瘤,经血管治疗技术可完全闭塞动脉瘤腔,GDC 的可操作性和治疗效果要优于 MDS。

Purpose:To evaluate comparative the efficacy of endovascular therapy with MDS and GDC in intracranial aneurysms.Material and Methods:28 patients with intracranial aneurysm (6 aneurysms with a wide neck and 22 aneurysms with a narrow neck)underwent endovascular therapy with MDS in 9 cases and GDC in 19 cases.21 cases involved acute treatment after a- neurysm rupture with subarachnoid hemorrhage.8 cases involved selective-time treatment.An- giographic studies were performed immediately and six months after procedure.Results:Endovas- cular procedure were successful in 26 cases,failed in 2 cases.Embolization was complete in 2 cases with MDS and in 12 cases with GDC,subtotal(>70%)in 3 cases with MDS and in 4 cases with GDC,Partial(<70%)in 3 cases with MDS and in 2 cases with GDC.Follow-up angiography showed no re-open of aneurysm in 7 cases six months after embolization.Thromboembolism oc- curred in two cases within procedure,one recovered fully two weeks later,another remained critical deficits.One case was failed for endovascular therapy and died for re-rupture of aneurysm one week later.Conclusion:Intracranial aneurysm with a narrow neck may been completely em- bolized by endovascular therapy technique,GDC is more manageabl and better efficacy than MDS.