双微导管技术栓塞颅内宽颈不规则动脉瘤

Double microcatheter technique for detachable coil treatment of wide-necked and irregular intracranial aneurysms

目的评估双微导管技术在栓塞颅内宽颈、不规则动脉瘤的应用价值。方法收集经DSA造影确认的颅内宽颈不规整动脉瘤6例，采用单侧股动脉入路，把2支微导管置入动脉瘤腔内，由微导管内先后交替送入弹簧圈，待弹簧圈稳定后解脱，逐步达到致密填塞。结果6例动脉瘤均成功栓塞，瘤腔闭塞均〉90％。治愈5例，术中出血导致中残1例。随访6个月一2年，动脉瘤无复发。结论双微导管技术对于某些不规则的宽颈动脉瘤是一种较好的方法。

Objective To evaluate double microcatheter technique in performing detachable coil management for wide- necked and irregular intracranial aneurysms. Methods Six cases with DSA- proved wide- necked and irregular aneurysms were enrolled in this study. Unilateral femoral artery approach was adopted to perform the interventional management. Two microcatheters were inserted and subsequently placed in the aneurysmal cavity, then, the coils were delivered through the two microcatheters alternately. The coil was liberated when it was in stable condition. In this way the aneurysmal cavity was gradually densely obstructed. Results Successful embolization was achieved in all six cases. Over 90% of the aneurysmal cavity was occluded. Complete cure was obtained in five cases. Moderate disability was seen in the remaining one case, which was caused by intracranial bleeding due to aneurysm rupture occurred during interventional procedure. All the patients were followed up for 6 - 24 months, and during the follow- up period no recurrence of aneurysm was seen. Conclusion For the treatment of irregular and wide-necked aneurysms, double mierocatheter technique is an ideal therapeutic means.