颅内微小动脉瘤的血管内治疗

The endovascular treatment for intracranial microaneurysms

目的探讨血管内介入治疗颅内微小动脉瘤的疗效并进行分析。方法回顾性分析34例微小动脉瘤(共35个动脉瘤)病人的临床资料,均采用血管内栓塞治疗,其中栓塞加支架辅助治疗3例。结果动脉瘤完全填塞28个,瘤颈残留7个。术中无动脉瘤破裂,术后脑梗死8例。30例病人术后3个月复查DSA,残颈无增大表现而继续临床观察。随访34例,时间12个月,完全康复30例,遗留轻微神经功能障碍4例。结论对于已破裂的微小动脉瘤,在血管内介入治疗过程中,通过采取相应技巧,预防出血及缺血性并发症,可获得较好的临床疗效。

Objective To explore and analyze the efficacy of endovascular treatment for intracranial microaneurysms. Methods Clinical data of 34 patients with microaneurysms （35 aneurysms） were analyzed retrospectively. Endovascular embolization was performed in 34 patients including stent-assisted in 3. Results Complete embolization was achieved in 28 aneurysms and residual neck was seen in 7. No rupture occurred during operation, but infarction in 8 patients postoperatively. Digital subtraction angiography was reperformed in 30 patients 3 months after operation and results showed no enlargement of the residual neck and clinical observation was continued. All the patients were followed up for 12 months, complete recovery was achieved in 30 patients and slight nerve dysfunction in 4. Conclusions Ruptured intracranial microaneurysms can have good clinical outcome by adopting relevant techniques for preventing hemorrhage and ischemic complications during endovascular therapy.