电解可脱式弹簧圈栓塞治疗颅内动脉瘤破裂

Evaluation of ruptured intracranial aneurysm treated by endovascular embolization with GDC

目的 探讨血管内电解可脱式铂金微弹簧圈 (GDC)早期栓塞治疗破裂后颅内动脉瘤的临床价值。方法 对 15例破裂后颅内动脉瘤施行血管内GDC早期栓塞治疗 ,15例患者按Hunt Hess分级 :I级 8例、II级 6例、IV级 1例 ,所有病例均经DSA造影和CT扫描诊断。结果 GDC栓塞手术成功13例 ,占 86 .7% (13/ 15 ) ;13例随访 3～ 2 5个月无再次出血和并发症 ,其中 2例 6个月后复查DSA未见复发 ,全部病例头颅正侧位片显示GDC形态、位置无改变 ;栓塞手术失败的 2例患者分别于术后第 4天和 4个月死亡。结论 早期GDC血管内栓塞治疗破裂后颅内动脉瘤为有效方法 ,可以防止再次破裂出血。

Objective To explore the clinical value of endovascular embolization treatment with Guglielmi detachable coil (GDC) for the patients with ruptured intracranial aneurysm. Methods 15 cases of patients with ruptured intracranial aneurysm were undengone endovascular embolization with GDC. According to Hunt Hess classification, 8 belonged to grade Ⅰ, 6 for grade Ⅱ, and 1 in grade Ⅳ. All the patients were diagnosed with cerebral DSA and CT scan. Results 13 cases of the 15 patients (86.7%) were succeeded in embolization with GDC. Other 2 cases were failed with embolization, died of hemorrhage on the fourth day and in fourth month respectively. There were no complications and hemorrhage in the 13 cases in the follow up 3 to 25 months. Other follow up methods all showed normal appaerance and position including skull X ray films of 13 patients and carotid artery DSA of 2 patients at an interval of 6 months. Conclusion Endovascular embolization treatment with GDC is an effective method for ruptured intracranial aneurysm to avoid hemorrhage.