介入栓塞术治疗颅内破裂前循环微小动脉瘤的临床疗效和安全性

The clinical efficacy and safety of interventional embolization in the treatment of intracranial ruptured anterior circulation microaneurysms

目的探讨介入栓塞术治疗颅内破裂前循环微小动脉瘤的临床疗效和安全性。方法回顾性分析2018年2月至2019年3月在我院应用介入栓塞术治疗的破裂前循环微小动脉瘤患者14例的临床资料,应用术后即刻造影后Raymond分级、随访复发率及改良Rankin量表评分评估手术疗效,以围术期手术相关并发症发生率及随访复查载瘤动脉狭窄、弹簧圈脱出发生率评价手术安全性。结果14例患者中,应用单纯弹簧圈栓塞12例,支架辅助栓塞1例;术后即刻造影示致密栓塞9例(64.3%),瘤颈残留4例(28.6%),手术失败1例;患者围术期均未发生手术相关并发症;术后3~6个月随访结果显示,完全闭塞11例、弹簧圈袢部分脱出至载瘤动脉1例、瘤颈残留1例。患者术后6个月mRS评分均为0~1分。结论颅内前循环破裂微小动脉瘤患者应用介入栓塞术治疗安全有效。

Objective To explore the clinical efficacy and safety of interventional embolization in the treatment of intracranial ruptured anterior circulation microaneurysms.Methods The clinical data of 14 patients with ruptured anterior circulation microaneurysms treated by interventional embolization in our hospital from February 2018 to March 2019 were analyzed retrospectively.The curative effect of the operation was evaluated by Raymond grading after immediate postoperative angiography,the recurrence rate during follow-up and scores of modified Rankin scale(mRS).The safety of the operation was assessed by the incidence rate of perioperative operation-related complications and the incidence rate of parent artery stenosis and spring coil prolapse during follow-up and reexamination.Results Among the 14 cases,12 cases were embolized with spring coil alone,and 1 case was embolized by the assistance of stent.Immediate postoperative angiography showed that 9 cases had pyknotic embolization(64.3%),4 cases had residual aneurysm neck(28.6%)and the operation of 1 case had failed.There were no operation-related complications during the perioperative period.Follow-up at 3 and 6 months after operation showed that 11 cases had complete occlusion,1 case had partial prolapse of spring coil loop,and 1 case still had residual aneurysm neck.The mRS scores of the 6 months after the operation kept being 0-1 point.Conclusion Interventional embolization treatment is safe and effective for intracranial ruptured anterior circulation microaneurysms patient.