破裂性前交通动脉瘤的栓塞治疗(附41例报告)

Treatment of ruptured anterior communicating artery aneurysms with GDCs: a report of 41 cases

目的 :总结 41例破裂性前交通动脉瘤急诊血管内栓塞治疗的经验和体会。方法 :采用电解可脱卸弹簧圈 (guglielmidetachable coil,GDC)作动脉瘤内填塞治疗。结果 :动脉瘤完全闭塞 2 3例 ,>90 %闭塞 12例 ,<90 %闭塞 6例 ,二次填塞 2例 ,栓塞后复发经手术治愈 1例。术后脑梗死 7例、死于肺部并发症 1例、植物生存 1例。随访 1～ 2 0个月 ,治疗结果稳定。颅内多发动脉瘤 4例 ,其中 3例 1次手术同时全部栓塞。 结论 :早期采用血管内栓塞治疗前交通动脉瘤效果好。虽然有较高的脑梗死发生 。

Objective: To summarize the experience of 41 cases of ruptured anterior aneurysms embolized with GDCs. Methods: All aneurysms were embolized with GDCs. Results: Complete embolization was achieved in 23 aneurysms, subtotal in 12, and partial in 6. Two cases was cured by the second time emblization. One case of recurrent aneurysm after GDC treatment was cured by surgical clipping. Brain infarction was noted in 7 cases after the endovascular procedure, and one of them died of pneumonia, another one was in permenent coma. One to 20 months follow up showed a steady result. Three of 4 cases with mutil intracranial aneurysms were treated in one procedure. Conclusion: The result of urgent or sub urgent endervascular treatment of ruptured anterior communicating artery aneurysms is good. Although there is a relatively high risk of local brain infraction, the clinical outcome is satisfactory.