前交通动脉破裂动脉瘤的血管内介入治疗

Intervention therapy for ruptured anterior communicating artery aneurysms

目的总结前交通动脉破裂动脉瘤的血管内介入治疗经验。方法回顾分析安徽医科大学第二附属医院采用单纯弹簧圈栓塞治疗的前交通动脉破裂动脉瘤患者临床资料。结果 39例前交通动脉破裂动脉瘤患者依据Hunt-Hess分级,其中Ⅱ级30例,Ⅲ级5例,Ⅳ级4例。39例动脉瘤均成功栓塞,37例治愈,术后随访均无复发或者再出血。术后3例患者发生严重脑血管痉挛,经治疗后明显好转。结论血管内介入治疗是前交通动脉破裂动脉瘤的有效治疗方法。术后早期引流血性脑脊液、积极药物治疗可以减少术后并发症。

Objective To explore the experience of endovascular intervention therapy on ruptured anterior communicating artery （ AComA） aneurysms. Methods The clinical data of 39 consecutive cases with ruptured AComA aneurysm treated by coiling in our hospital were retrospectively analyzed. Results These patients were diagnosed with computed tomography angiography （ CTA） or digital subtraction angiography （DSA）. The patients were classified by Hunt-Hess classification as followed： GradeⅡ（30 patients）, Grade Ⅲ （5 patients）, GradeⅣ （4 patients）. All cases were successfully treated by coiling procedure, among whom 37 patients were cured. 3 patients suffered from serious vasospasm and recovered completely after drug therapy. Lumbar puncture or continued lumbar drainage were done to treat vaso-spasm. Conclusion Endovascular treatment is an effective procedure to treat AComA ruptured aneurysm. Early drainaging hemorrhagic ce-rebrospinal fluid and united drug therapy are important in reducing the postoperative complications.