微弹簧圈囊内栓塞急性出血期颅内动脉瘤

Endovascular treatment of the acutely ruptured intracranial aneurysm with coils

目的 急性出血期颅内动脉瘤的微弹簧圈囊内栓塞。方法 股动脉或颈动脉 Ｓｅｌｄｉｎｇｅｒ○ｓ 穿刺。用ｐｕｓｈｅｒ 推入自制弹簧圈或用 Ｍ Ｄ Ｓ 系统送入合适长度的微弹簧圈到动脉瘤腔内填塞动脉瘤腔。结果 本组无一例死亡。４２ 例动脉瘤中３８ 例 （９０ ％ ） 术后立即造影动脉瘤完全栓塞， 另外４ 例（１０ ％ ） 动脉瘤部分栓塞。２０ 例病人接受 Ｄ Ｓ Ａ 复查均未见动脉瘤复发。不全栓塞的４ 例动脉瘤中１ 例后交通动脉瘤半年后行 Ｄ Ｓ Ａ 见动脉瘤颈部扩大， 行二次栓塞， １ 例基底动脉瘤半年后虽经二次栓塞治疗， 一年后复查病人动脉瘤仍在继续扩大， １ 例椎动脉瘤和１ 例前交通动脉瘤 Ｄ Ｓ Ａ 复查见动脉瘤腔已完全闭塞。结论 对于囊状动脉瘤 Ｓ Ａ Ｈ 急性期的病人， 微弹簧圈动脉瘤腔内栓塞治疗是较为安全有效的方法。

Objective To setup an endovascular treatment of the acutely ruptured intracranial aneurysm with coils. Methods Carotid or femoral artery approach were selected. Cordis 3F/2 5F catheter was positioned inside the aneurysm. Free and/or MDS coils were pushed into the aneurysmal lumen. Results No death occurred in our group. 38 of 42(90%) aneurysms were completely occluded after the first procedure. 4(10%) were partly occluded, one of which was complerely occluded in second procedure half year late, two were demonstrated thrombosis by follow up DSA, and the other giant aneurysm was not completely occluded although 2 procedure were performed. Follow up DSA were in 20 of 42 cases including the 4 retreated aneurysms, no recanalization were found in completely occluded cases. Conclusion Coil occlusion is a safe and effective method for treatment of ruptured aneurysm.