以电解可脱性弹簧圈急诊栓塞破裂动脉瘤

Emergent embolism of ruptured intracranial aneurysm with guglielmi detachable coil

目的 :总结 2 7例以电解可脱性弹簧圈 (GDC)急诊栓塞破裂动脉瘤的体会。 方法 :自发性蛛网膜下腔出血患者 2 7例。女 17例 ,男 10例 ,年龄 40～ 85岁。 2 5例在急性 SAH发病 12 h内行 GDC动脉瘤栓塞。动脉瘤的大小为 3～ 2 2 m m。 6例动脉瘤颈较宽的患者行瘤颈成形术。术后常规给予低分子肝素 7d。 7名患者 GDC栓塞后鞘内给予 t- PA.结果 :动脉瘤栓塞后随访 3个月到 1年 ,无 1例发生再出血。恢复良好 17例 ,中等 5例 ,2例恢复差 ,3例死亡。有 6例发生血管痉挛。结论 :用GDC急诊栓塞为治疗破裂动脉瘤开拓了新途径。

Objective: To summarize 27 cases of ruptured intracranial aneurysms urgently embolized with guglielmi detachable coil (GDC). Methods: Twenty seven patients aged 40 85 years old were studied. Seventeen were female and 10 were male. Twenty five were urgently treated with GDC embolization within 12 h after acute subarachnoid hemorrhage. Aneurysm size was from 3 to 22 mm. Neck plasty (remodeling) technique was performed in 6 wide necked aneurysms. Seven patients were treated with intrathecal t PA administration after GDC embolism. Results: During the follow up period (3 months to 1 year), no aneurysm presented rerupture. Good recovery was got in 17 patients, moderate in 5 patients and poor in 2. Three patients died. Vasospasm occurred in 6 patients. Conclusion: GDC embolism is a promising treatment for ruptured intracranial aneurysms.