颅内破裂动脉瘤急性期血管内治疗的临床分析

Endovascular treatment of acutely rupture intracranial aneurysms (report of 40 cases)

目的探讨颅内破裂动脉瘤急性期血管内栓塞治疗的疗效。方法回顾性分析2006～2009年收治的40例颅内破裂动脉瘤患者的临床资料。所有患者均于出血后72h内行血管内栓塞治疗,其中11例宽颈动脉瘤中,6例应用支架辅助弹簧圈栓塞,4例应用球囊瘤颈成形辅助弹簧圈栓塞,1例应用双导管技术栓塞;其余动脉瘤均仅用弹簧圈栓塞。结果本组40例共47个动脉瘤,100%栓塞39个,80%～90%栓塞3个,50%～60%栓塞2个,栓塞失败2个,多发动脉瘤中未作处理1个。术后随访3～6月,脑血管造影复查25例,未见动脉瘤复发,也无再出血病例。结论颅内破裂动脉瘤急性期应用血管内栓塞不仅安全高效,而且可以防止再出血及减少并发症,降低患者死亡率和致残率。

Objective To explore the effect of endovascular embolization on the acutely rupture intracranial aneurysms.Methods The clinical data of 40 patients with 47 acutely ruptured intracranial aneurysms,who received endovascular embolization within 72 hours after the rupture,were analyzed retrospectively.Of 11 wide-neck aneurysms,6 were endovascularly embolized by stent-assisted Guglielmi detachable coils （GDC）,4 by GDC after remodeling of aneurismal necks with balloons,1 by the double catheters technique-assisted GDC.The other aneurysms were embolized only by GDC.Results Of 47 aneurysm in 40 patients,39 were embolized by 100%,3 by 80%～90%,2 by 50%～60%,2 unsuccessfully and 1 in a patient with multi-aneurysms was not treated.No rebleeding due to aneurismal rupture recurred in all the patients during the following up of 3～6 months after the embolization.Conclusion The endovascular embolization with GDC,which can prevent rerupture of the aneurysms and improve the prognoses,is a safe and effective method to treat acutely ruptured intracranial aneurysms.