颅内多发动脉瘤的血管内治疗

Endovascular treatment for multiple intracranial aneurysms

目的：探讨颅内多发动脉瘤血管内治疗的适应证、可行性、疗效及预后。方法：收集2011年4月至2014年9月于我科诊断并行栓塞治疗的63例颅内多发动脉瘤患者的临床资料,并对其疗效和适应证进行回顾性分析。结果：63例患者共150个动脉瘤,其中47例为2个,10例为3个,4例为4个,2例为5个。55例一期栓塞所有动脉瘤,1例分次栓塞动脉瘤,7例只处理责任动脉瘤。共栓塞动脉瘤139个,其中138个（99.3%）完全栓塞,1个（0.7%）为次全栓塞,80个使用支架。出院时格拉斯哥预后评分（Glasgow outcome scale,GOS）：5分45例,4分7例,3分6例,2分5例。出院后5～48月27例患者进行DSA随访,3例3个动脉瘤复发,其中1例同时伴有新生。结论：血管内治疗能一期栓塞颅内多发动脉瘤,疗效较好,致密栓塞以及防治术后并发症是保证疗效的重要因素。

Objective：To evaluate the results of endovascular treatment for multiple intracranial aneurysms. Methods：The clinical data of 63 patients with multiple intracranial aneurysms between April 2011 and September 2014 in our department were collected and retrospectively analzyed. Results ：A complete endovascular occlusion was achieved in 55 patients in the first session;one patient achieved complete embolization by twice surgery;responsible aneurysms was occluded in seven patients. All 63 patients harbored150 aneurysms;47 patients harbored 2 aneurysms,10 patients harbored 3 aneurysms,4 patients harbored 4 aneurysms, 2 patients harbored 5 aneurysms. Totally 139 embolism aneurysms were found, of which 138 cases（99.3%）were complete embolism aneurysms and 1 case（0.7%）was neck remnants;80 stents were used. Glasgow outcome scale（GOS）score at discharge：5 points in 45 cases,4points in 7 cases,3 points in 6 cases,2 points in 5 cases. Follow-up DSA was conducted for 27 patients after discharge;3 cases demonstrated three recurrences of the aneurysms,including 1 case with a new aneurysm. Conclusion：The efficacy of endovascular treatment for multiple intracranial aneurysms at stage I is relatively good. Dense embolization and reducing the complications during the perioperative period are the key factors of better outcome.