电解可脱弹簧圈栓塞治疗颅内破裂动脉瘤的近期疗效及影响因素

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

目的 总结电解可脱弹簧圈GDC栓塞治疗颅内破裂动脉瘤的近期疗效及其相关影响因素。 方法 应用GDC栓塞治疗123例，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I～II级病人中，预后良好者（GOS评分4～5分）为100％，III～V级病人中分别为95％、78％、50％，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％、6％、2％，宽颈动脉瘤中分别为81％、13％、6％，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有关，还受瘤体大小的影响。载瘤动脉的形态影响GDC栓塞的操作，采用双弯塑形，有利于动脉瘤的超选与致密填塞。而临床预后与Hunt＆Hess分级呈负相关。

Objective To investigate the efficiency and relevant factors of embolization of ruptured intracranial aneurysms．Method All the ruptured aneurysms were embolized with GDC． We analyzed the effect of aneurysmal geometry on embolization procedure as well as Hunt＆Hess grade on clinical outcome． Result The ratio of recovery good and well was 100 percents of paitients with Hunt＆Hess grade I－II,while 95％,78％,and 50％ in Grade III－V respectively． The complete occlusion,subtotal occlusion,partial occlusion were obtained in 92％,6％ and 2％ of narrow－necked aneurysms,while 81％,13％,and 6％ in wide－necked aneurysms． The effect of GDCs embolization in small and middle aneurysms were significant different with the large aneurysms． Conclusion The degree of occlusion depends not only on the size of the ancurysmal neck,but also the size of the aneurysm． The procedures of embolization with GDCs were affected by the morphology of parent artery,and double－angled shaping may be favorable for super－selective and tight embolization of aneurysms． The clinical outcome had a negative correlation with Hunt＆Hess grade．