颈内动脉分叉部动脉瘤的血管内治疗

Embolization treatment of internal carotid arterial bifurcation aneurysms

目的报告及评价13例颈内动脉分叉部动脉瘤的治疗方法及结果。方法自1998年以来对13例颈内动脉分叉部动脉瘤采取多种技术联合治疗,其中用3D-GDC电解弹簧圈篮筐技术栓塞9例,用球囊载瘤动脉再塑形联合GDC栓塞2例。结果完全栓塞7例,4例不全栓塞,2例用球囊再塑形技术治疗的动脉瘤1例完全栓塞,1例不全栓塞。死亡1例,为术后动脉瘤破裂出血,2例大脑前动脉梗塞,1例大脑中动脉梗塞。结论颈内动脉分叉部动脉瘤采用多种技术联合栓塞,术后严密观察意识及肢体活动情况,足量抗凝、扩容等治疗是非常重要的。

Objective To report and analyse the methods and results of embolization of13cases of internal carotid arterial bifurcation aneurysms.Method13cases of internal carotid bifurcation aneurysms had been embolized with the combined techniques,9cases were occluded with″basket″technique of3D-GDC,2were embolized with combination of″remodelling technique″of parent arteries with balloons and GDCs embolized.Result7cases were totally occluded.4were subtotally occluded.In2cases embolized with balloons,1was completely embolized,1was subtotally occluded.1patient was dead of post-operative rebleeding.Anterior cerebral artery infarction occurred in2cases,middle cerebral artery and brain stem infarction in1case.Conclusion The satisfactory results of treatment of internal carotid bifurcation aneurysms could be obtained with the combined use of various embolization technique.It is very important to give anticoagulant therapy postoperatively and observe neurosystem symptoms carefully.