双微导管技术治疗急性期前循环破裂宽颈动脉瘤13例

Dual microcatheter technique for the treatment of acute ruptured wide-necked aneurysm of anterior circulation: preliminary results in 13 patients

目的评价双微导管技术栓塞治疗急性期前循环破裂宽颈动脉瘤的可行性和有效性。方法回顾性分析 2016 年 1 月至 2018 年 2 月采用双微导管技术栓塞治疗 13 例前循环破裂宽颈动脉瘤患者临床资料并分析其技术优势。 13 例患者中前交通动脉瘤 6 例,后交通动脉瘤 4 例,大脑中动脉瘤2 例,脉络膜前动脉瘤 1 例。结果术后即刻造影显示治疗成功 12 例,其中 10 例动脉瘤完全致密栓塞, 2 例大部分栓塞,载瘤动脉及其正常分支血管血流通畅;1 例栓塞失败,予支架辅助弹簧圈栓塞。术后6 个月复查造影显示 10 例动脉瘤完全治愈,2 例复发。结论双微导管技术栓塞治疗急性期前循环破裂宽颈动脉瘤安全有效,具有操作简单、并发症少等优势,但需严格掌握适应证。

Objective To evaluate the feasibility and efficacy of dual microcatheter technique in endovascular treatment for acute ruptured wide - necked aneurysm of cerebral anterior circulation. Methods The clinical data of 13 patients with acute ruptured wide - necked aneurysm of cerebral anterior circulation, who received interventional embolization therapy by using dual microcatheter technique during the period from January 2016 to February 2018, were retrospectively analyzed. The technical advantages of dual microcatheter technique were discussed. Among the 13 patients, anterior communicating aneurysm was found in 6, posterior communicating aneurysm in 4, middle cerebral artery aneurysm in 2 and anterior choroidal aneurysm in one. Results Angiography performed immediately after the procedure showed that successful embolization of the aneurysm was obtained in 12 patients, including complete dense embolization (n=10) and almost complete embolization (n =2), and the parent arteries as well as their normal branches remained unobstructed. Embolism failure was seen in one patient, and further stent-assisted coiling embolization had to be carried out. Six months after the treatment, reexamination with angiography revealed that complete cure of aneurysm was achieved in 10 patients, and recurrence of aneurysm was detected in 2 patients. Conclusion For the treatment of acute ruptured wide - necked aneurysm of cerebral anterior circulation, interventional embolization therapy with dual microcatheter technique is safe and effective, this technique is simple with less complications, but its indications should be strictly observed.