颅内微小动脉瘤介入治疗的疗效分析

Efficacy of interventional treatment for very small intracranial aneurysms

目的探讨血管内介入治疗颅内微小动脉瘤的安全性、有效性及技术要点。方法回顾性研究,收集2022年8月至2023年8月间作者主刀的颅内微小动脉瘤患者共21例(微小动脉瘤25枚),分析手术方式、术后栓塞程度、并发症率、预后及术后6-8个月随访结果。结果本组患者的平均年龄为58.6(43-75)岁,男性占比38.1%;20枚(80.0%)为破裂动脉瘤;术后即刻栓塞率:RaymondⅠ级19枚(76.0%),RaymondⅡ级6枚(24.0%);术中动脉瘤破裂1枚(4.0%)。术后6-8个月随访的病例中,复发1枚(4.0%);术后6个月MRS评分0分20例(95.2%),1分1例(4.8%)。结论虽然血管内介入治疗微小动脉瘤较其他类型动脉瘤有着更高的术中破裂等并发症发生率,但通过良好的技术运用及谨慎的操作,仍能取得较好疗效。

Objective To explore the safety,effectiveness and technical points of endovascular interventional therapy for very small intracranial aneurysms.Methods From August 2022 to August 2023,a total of 21 cases(25 parts of very small intracranial aneurysms)operated by the authors were collected.The surgical methods,postoperative embolization degree,complication rate,prognosis and 6-8 month follow-up results were analyzed.Results The average age of the patients in this group was 58.6(43-75)years old,and the male ratio was 38.1%.20(80.0%)cases were ruptured aneurysms.The immediate postoperative embolization rate was 19(76.0%)in Raymond grade I,6(24.0%)in Raymond grade II,with 1(4.0%)case of aneurysm broken in the operation.Among the cases followed up from 6 to 8 months after operation,1 case recurred(4.0%),and MRS score was 0 in 20 cases(95.2%)and 1 in the other 1 case(4.8%)6 months after operation.Conclusions Although endovascular interventional therapy for very small aneurysms has a higher incidence of complications such as intraoperative rupture than other types of aneurysms,it can still achieve good results through good technical application and careful operation.