微导管辅助栓塞颅内宽颈动脉瘤的疗效分析

Microcatheter-assisted embolization for intracranial wide-necked aneurysms(report of 7 cases)

目的探讨微导管辅助栓塞治疗颅内宽颈动脉瘤的可行性和疗效。方法回顾性分析微导管辅助栓塞治疗的7例颅内宽颈动脉瘤的临床资料。5例破裂动脉瘤,2例未破动脉瘤。治疗时,选择工作角度后,首先将辅助微导管成功超选至载瘤动脉远端血管;然后将弹簧圈微导管超选至动脉瘤内,在微导管的辅助下通过小心填塞弹簧圈栓塞动脉瘤,待动脉瘤栓塞满意后小心撤除微导管。结果术后即刻造影显示,6例Raymond分级Ⅰ级栓塞,1例Ⅱ级栓塞。出院时,GOS评分4分1例,5分6例。术后6个月,4例复查DSA示载瘤动脉通畅,动脉瘤瘤腔未见明显显影,动脉瘤未见明显复发;2例电话随访无明显神经功能障碍。结论微导管辅助栓塞作为破裂急性期或者伴有载瘤动脉明显狭窄和迂曲的颅内宽颈动脉瘤的治疗是安全有效的。

Objective To evaluate the feasibility and efficacy of endovascular treatment for intracranial wide-necked aneurysms with microcatheter-assisted coiling technique.Methods The clinical data of 7 patients with intracranial wide-necked aneurysm who underwent microcatheter-assisted coiling were analyzed retrospectively.During the procedure of intervention,the auxiliary microcatheter was firstly selected to the distal vessel of the parental artery after selecting the working angle for treatment.The aneurysms were then packed with coil when the coiling microcatheter was superselective introduced into the aneurysm.Last,the microcatheter was carefully removed when the embolization of the aneurysm was satisfied.Results Of 7 patients,5 patients had rupture aneurysms and 2 had unrupture aneurysms.The DSA immediately after the embolization showed that Raymond gradeⅠembolization was acheived in 6 patients and gradeⅡin 1.At discharge,the GOS score was 4 in 1 patient and 5 in 6 patients.The DSA of 4 patients 6 mongths after the embolization showed no recurrence of the aneurysms.Two patients had no obvious neurological dysfunction by telephone follow-up.Conclusions Microcatheter-assisted embolization is a safe and effective treatment method for intracranial wide-necked aneurysms in the acute stage of rupture or with obvious stenosis and tortuosity of the parent artery.