介入栓塞治疗颅内微小动脉瘤的临床研究

Clinical study of interventional embolization for the treatment of tiny intracranial aneurysms

目的：探讨血管内栓塞治疗颅内微小动脉瘤（直径≤3．0 mm）的技巧及疗效。方法2010年12月-2013年7月收治颅内微小动脉瘤患者12例，其中窄颈动脉瘤7例（颈体比≤1/2），行单纯弹簧圈栓塞治疗；宽颈动脉瘤5例（颈体比〉1/2），使用支架辅助弹簧圈栓塞治疗。按Raymond 分级方法，术后即刻评价栓塞效果及并发症，术后30 d 根据GOS 评分评定，并进行电话及造影随访。结果12例患者的12枚动脉瘤均成功栓塞，成功率为100%。术后即刻造影示动脉瘤完全栓塞8枚（66．7%），瘤腔残留4枚（33．3%）。GOS 评分评定预后5级12例。12例患者术后电话随访1-12个月，无动脉瘤再次破裂出血。结论采用介入栓塞治疗颅内微小动脉瘤可行，但安全性及疗效仍需进一步观察。

Objective To explore the therapeutic efficacy of endovascular embolization for the treatment of tiny intracranial aneurysms （≤3.0 mm） and to discuss its technical skill. Methods During the period from Dec. 2010 to July 2013, a total of 12 patients with tiny intracranial aneurysms （≤3.0 mm） were admitted to authors’ hospital to receive endovascular embolization therapy. Of the 12 patients, narrow-necked aneurysm （neck-to-body ratio ≤0.5） was seen in 7 and embolization with coils only was carried out, while wide-necked aneurysm （neck-to-body ratio 〉 0.5） was seen in 5 and stent-assisted coils embolization was adopted. Based on Raymond grading standard, the immediate therapeutic results were evaluated, and the procedure-related complications were recorded. Thirty days after the treatment , GOS grade was used to assess the results. Follow-up evaluation with angiography or through call was conducted. Results Successful embolization of the aneurysm was obtained in all the 12 aneurysms , with a success rate of 100%. Angiography performed immediately after the treatment showed that complete embolization was achieved in 8 aneurysms （66.7%） and residual aneurysm cavity was seen in 4 aneurysms （33.3%）. GOS grading indicated that 12 cases belonged to grade V. The 12 patients were followed up for 1 - 12 months through telephone , and no re-bleeding occurred. Conclusion For the treatment of tiny intracranial aneurysms （≤ 3.0 mm）, endovascular embolization is feasible although its safety and efficacy need to be further observed.