颅内动脉瘤血管内栓塞治疗的临床随访研究

Short-term and long-term effectiveness of endovascular embolization in treating intracranial aneurysms

目的 观察颅内动脉瘤血管内栓塞治疗后近期及远期效果。方法 对 173例颅内动脉瘤血管内栓塞治疗后的病人进行临床随访 ,了解栓塞治疗后 3～ 2 4个月内临床症状恢复情况 ,部分病人用数字减影脑血管造影的方法 ,了解颅内动脉瘤栓塞后复发情况及复发的原因。结果 经对173例病人的临床随访 ,均未见再出血 ,临床症状逐步恢复 ,其中 5 6例动眼神经麻痹病人 ,1例于 1周内恢复 ,5 2例于 1年内恢复 ,3例于 1.5年内恢复。 10例视力下降病人 ,6个月后视力均有不同程度的恢复。其中 84例病人行脑血管造影复查 ,5例复发 ,其中 2例因可脱性弹簧圈吸收造成复发 ,3例因弹簧圈移位 ,瘤蒂显影 ,无一例再发生蛛网膜下腔出血。结论 颅内动脉瘤行血管内栓塞治疗 ,因其创伤小、疗效显著。

Objective To study the short term and long term effectiveness of endovascular embolization with Guglielmi detachable coil (GDC) or mechanical detachable spiral (MDS) intreating intracranial aneurysms. Methods 362 patients with cerebral aneurysms were treated by endovascular embolization with GDC or MDS. Follow up interviews in the form of correspondence or hospital visit were conducted to 173 of those patients 3～24 months after the treatment. DSA cerebral artery angiography was made to 84 patients. Results The clinical symptoms disappeared gradually after the treatment among all of the interviewes. No subarchnoid hemorrhage was found. All of the 56 cases with ocular paralysis recovered, 1 case in a week, 52 in a year, and 3 in 18 months. Visual acuity improved to different degrees among 10 cases with visual disturbance in 6 months. Five of the 84 patients who received DSA angiography showed recurrence of aneurysm. Then cause of recurrence was absorption of MDS coils in 2 cases and shifting of the coil in 3 case. Conclusions Endovascular embolization is an effective method in treating the intracranial aneurysms with minimal invasiveness and few complications.