大脑中动脉分叉部动脉瘤的血管内介入治疗

Endovascular interventional embolization for the treatment of aneurysms located at the bifurcation of middle cerebral artery

目的探讨介入栓塞治疗大脑中动脉分叉部动脉瘤疗效。方法 2009年1月—2013年5月经介入栓塞治疗大脑中动脉分叉部动脉瘤患者21例,其中7例行弹簧圈栓塞,12例行支架辅助栓塞,2例采用双微导管技术。结果术后造影显示完全栓塞14例,瘤颈残留2例,大部分栓塞5例,术中出血1例,术后小面积梗死1例。影像随访17例未见动脉瘤复发。结论未破裂和破裂未形成较大血肿的大脑中动脉分叉动脉瘤首选介入栓塞治疗效果良好。

Objective To evaluate the therapeutic efficacy of endovascular embolism in treating aneurysms located at the bifurcation of middle cerebral artery. Methods During the period from Jan. 2009 to May 2013 at authors’ hospital, a total of 21 patients with intracranial aneurysms located at the bifurcation of middle cerebral artery were treated with interventional embolization. Of the 21 cases , steel coils were used in 7, stent-assistant embolization was adopted in 12, and dual-microcatheter technique was employed in 2. The results were analyzed. Results Postoperative angiography showed that complete embolization of the aneurysm was achieved in 14 patients, residual neck was detected in 2 patients and subtotal obliteration of the aneurysm was seen in 5 patients. Procedure-related complications occurred in 2 patients, including cerebral bleeding during operation （n = 1） and postoperative small area cerebral infarction. Seventeen patients were followed up for 6 months, and follow-up angiography showed that no recurrence of aneurysm was seen. Conclusion For un-ruptured, or ruptured with no big hematoma, intracranial aneurysms located at the bifurcation of middle cerebral artery, endovascular interventional embolization is the treatment of choice.