电解可脱卸弹簧圈栓塞治疗颅内破裂动脉瘤的疗效及影响因素

Embolization of ruptured intracranial aneurysms with Guglielmi detachable coils: the efficiency and relevant factors

目的 :探讨电解可脱卸弹簧圈 ( Guglielmi detachable coil,GDC)栓塞治疗颅内破裂动脉瘤的近期疗效及相关影响因素。方法 :应用 GDC栓塞治疗 1 2 3例 1 57枚动脉瘤 ,分析动脉瘤几何形态学、病情严重程度对栓塞效果及临床治疗的影响。结果 :Hunt-Hess分级 ～ 级患者中 ,预后良好者 ( GOS>3分 )为 1 0 0 % , 、 ～ 级患者中分别为 95.0 %、76.0 % ;窄颈动脉瘤完全栓塞率、大部栓塞率及部分栓塞率分别为 92 .4 %、5.7%、1 .9% ,宽颈动脉瘤中分别为 80 .8%、1 3 .5%、5.8% ,大动脉瘤的疗效明显低于小动脉瘤。结论 :动脉瘤的栓塞程度不仅与瘤颈大小有关 ,还受瘤体大小的影响。而临床预后与 Hunt-Hess分级呈负相关。

Objective: : To investigate the efficiency and relevant fa ct ors of embolization of the ruptured intracranial aneurysms with Guglielmi detach able coils(GDC). Methods: All the ruptured aneurysms were emboli zed with GDC. We analyzed the effect of aneurysmal geometry on embolization proc edure as well as Hunt-Hess grade on clinical outcome. Results: The ratio of good recovery was 100 percent in Hunt-Hess grade Ⅰ-Ⅱ, while 95. 0% and 76.0% in grade Ⅲ,Ⅳ-Ⅴ respectively. The total occlusion, subtotal occl usion, partial occlusion were obtained in 92.4%, 5.7% and 1.9% of narrow-necked aneurysms, but 80.8%, 13.5%, and 5.8% in wide-necked aneurysms. The results of embolization with GDC in small and middle aneurysm were significantly different with the large aneurysms. Conclusion: The aneurysm occlusion de pends not only on the size of the neck, but also on that of the aneurysm. The cl inical outcome has a negative correlation with Hunt-Hess grade.