电解可脱性弹簧圈超早期栓塞颅内破裂囊性动脉瘤

The treatment of ruptured intracranial aneurysms with GDC embolization at the super-early stage

目的总结22例电解可脱性弹簧圈（Guglielmidetachablecoil，GDC）超早期栓塞颅内破裂囊性动脉瘤的经验。方法女14例，男8例。年龄40～85岁，平均62岁。均以自发性蛛网膜下胜出血急诊入院手术。按HESS－HUNT分级Ⅲ级9例，Ⅳ级13例。基底动脉顶端动脉瘤8例，前交通动脉动脉瘤5例，颈内动脉－后交通动脉动脉瘤5例，海绵窦部动脉瘤2例，大脑中动脉分叉部动脉瘤2例。6例行球囊瘤颈成形术。术后常规给予低分子肝素7d。结果随访3个月到1年，无一例发生再出血。恢复良好14例，中等3例，2例恢复差，3例死亡。结论用GDC超早期栓塞治疗颅内破裂囊性动脉瘤是一个有效方法。

Objedive To study ruptured intracranial saccular aneurysms urgently treated with GDC embolization. Method 22patients aged from 40-85 years were studied. 14 were female and 8 were male. 20 cases were urgently treated with GDC embolization within 12 hours afer acute SAH. The locations of the aneurysms covered almost all over the anterior and posterior circulation. Aneurysms size is from 3 mm to 22 mm. Neck plasty (remodeling) technique was performed in 6 wide-necked aneurysms. 6 patients were treated with intrathecal t-PA administration afer GDC embolization. Result During the follow-up period ranged from 3 months to 1 year, no one presents rerupture of their aneurysms. 3 patients died. Vasospasm occurred in 6 patients, it was associated with 2 deaths. Conclusion GDC embolization is a promising treatment for ruptured intracranial aneurysms that are not surgically clippable.