微导丝辅助技术在颅内动脉瘤栓塞治疗中的应用研究

Clinical evaluation of microwire assisted coiling for distal intracranial wide-necked aneurysms

目的 探讨微导丝辅助的瘤颈成形技术在弹簧圈栓塞治疗颅内动脉瘤中的价值、技术操作要点及临床应用前景。方法 本组包括 2 5例小型宽颈动脉瘤 (前交通动脉 12例 ,大脑中动脉分叉部12例 ,小脑后下动脉瘤 1例 )。微导管成功超选动脉瘤囊内 ,将撤出的微导丝再塑形后跨瘤颈部位放置 ,通过微导管内用电解可脱卸弹簧圈栓塞动脉瘤。结果 2 5例均获得成功 ,动脉瘤致密栓塞 ,载瘤动脉保持通畅 ,效果满意。短期影像随访 16例 ,动脉瘤无复发。结论 微导丝瘤颈成形术作为小型宽颈动脉瘤治疗技术是安全。

Objective To evaluate endovascular treatment for distal intracranial wide necked aneurysms with microwire assisted coiling technique. Methods Twenty five patients with ruptured small wide necked aneurysms were treated with this procedure including 12 aneurysms located in anterior communicating artery, 12 in bifurcation of middle cerebral artery and 1 in PICA. Microcatheters were firstly introduced into the aneurismal sacs. We remodelled the microwire in line with parent artery and advanced it across the aneurismal neck. The aneurysms were then packed with guglielmi detachable coil through microcatheter. Results Technical success was achieved in all cases with no associated complications. The aneurysms were totally occluded with patency of parent artery and the patients recovered uneventfully. The follow up of 16 cases, showed no recanalization of aneurysms. Conclusions Microwire assisted coiling is a novel alternative for endovascular treatment of distal, small wide necked aneurysm with satisfactory safety and economical efficacy.