支架结合电解可脱弹簧圈治疗宽颈后交通动脉瘤的初步体会

Treatment of posterior-communicating wide-necked aneurysms with endovascular stent and Guglielmi detachable coils

目的 总结血管内支架结合电解可脱弹簧圈 (Guglielmidetachablecoil,GDC)治疗宽颈后交通动脉瘤的临床体会。 方法 32例宽颈后交通动脉瘤 ,均先植入冠脉支架覆盖动脉瘤颈 ,再将微导管通过支架网孔超选进入动脉瘤腔 ,填塞GDC。 结果 32例患者 ,动脉瘤完全填塞 2 6例 ,90 %以上填塞 4例 ,6 0～ 70 %填塞 2例。所有载瘤动脉通畅 ,临床效果优良。 结论 血管内支架结合GDC是治疗宽颈后交通动脉瘤的有效方法 ,长期疗效有待进一步随访。

Objective To summarize our clinical experience in treating posterior-communicating wide-necked aneurysms using endovascular stent and Guglielmi detachable coils(GDCs). Methods The coronary stents were implanted across the neck of 32 posterior-communication wide-necked aneurysms. Microcatheters were introduced into the aneurysm sac through stent mesh, GDCs were used to embolize aneurysms. Results All operations were successful. Total occlusion was achieved in 26 patients, over 90% in 4, 60～70% in 2. The patients were perfectly recovered with patency of the parent arteries. Conclusion Endovascular therapy combined with stent implatation and GDC placement is a valid approach to the treatment of posterior-communication wide-necked aneurysms.