双微导管技术在栓塞颅内宽颈及不规则形动脉瘤中的应用价值

The Application Value of Dual Micro- catheter Technique in Embolization of Intracranial Wide- necked Aneurysms and Irregular- shaped Aneurysms

目的探讨双微导管技术在栓塞颅内宽颈及不规则形动脉瘤中的应用价值。方法选取2008年3月—2012年9月本院收治的颅内宽颈及不规则形动脉瘤患者32例,均采用双微导管技术进行治疗:将6F Envoy导引导管置入动脉瘤侧颈内动脉或椎动脉内,然后将10F和14F预塑形微导管分别在0.014英寸微导丝引导下送入动脉瘤体内,再根据动脉瘤大小决定是否分部填塞和保护分支血管。回顾性分析患者的治疗效果。结果除2例患者在术中出现不同程度的动脉瘤破裂出血而导致残疾外,其余患者术后均恢复良好,未发现有动脉瘤复发病例。结论对颅内宽颈及不规则形动脉瘤患者采用双微导管技术进行栓塞治疗,安全性和可靠性高,且手术操作方便、快捷、并发症少,值得在临床进一步推广应用。

Objective To discuss the application value of dual micro - catheter technique in embolization of intracrani- al wide - necked aneurysms and irregular - shaped aneurysms. Methods A total of 32 patients with wide - necked aneurysms or irregular - shaped aneurysms treated with dual micro - catheter technique between March 2008 and September 2012 in our hospital were included in this study. The 6F Envoy guiding catheter was put into the internal carotid artery or vertebral artery with aneu- rysms, then 10F and 14F pre fabricated micro catheters guided by 0. 014 inch micro guiding wire were put into the aneurysms, respectively. The partial packing and the protection for the branch vessels were done according to the size of aneu- rysm. Retrospective analyses of the patients＇ outcomes were done. Results There were two patients with varying degrees of intrao- perative aneurysm rupture during the operation, which resulted in disability. All other patients were recovered well, and there was no aneurysm recurrence. Conclusion The dual micro - catheter technique in embolizing wide - necked aneurysms and irregular - shaped aneurysms is safe and reliable with fewer complications, and the operation is convenient and fast, which may have signifi- cant clinical implications.