手工制作微导丝套索装置处理颅内动脉瘤栓塞过程中移位弹簧圈

摘要

Objective To investigate the method of handmade microwire lasso device for the management of coil migration during intracranial aneurysm embolization. Methods Two migration coils were removed from intracranial arteries using handmade microwire lasso rings. The first coil prolapsed completely from an aneurysm sac and flowed to the middle cerebral artery M2 segment. The second coil partially prolapsed out into a parent artery. The microwire lasso device was made of 4-0 silk thread and fixed using 0. 36 mm (0. 014 inch)microwire and 0. 43 mm (0. 017 inch)microcatheter. Results After removing 2 migration coils from intracranial arteries,angiography did not reveal vascular injury and thrombosis. There was no aneurysm rupture. After awaking from anesthesia,the patient did not have neurological deficit. The patient was followed up for 3 months after procedure. MR angiography confirmed the patency of related arteries. Conclusion The handmade microwire lasso device for the management of coil migration in the process of aneurysm embolization is a simple,effective,and economical method.%目的：探讨手工制作微导丝套索装置处理血管内栓塞颅内动脉瘤术中移位弹簧圈的方法。方法使用手工制作的微导丝套索环将2枚移位弹簧圈从颅内动脉中取出体外。第1枚弹簧圈完全脱出动脉瘤囊并飘逸至大脑中动脉M2段，第2枚弹簧圈部分脱入载瘤动脉。微导丝套索装置由动脉瘤栓塞术中使用的0.36 mm（0.014 in）微导丝和0.43 mm（0.017 in）微导管，以4-0缝合丝线固定制成。结果将2枚移位弹簧圈取出体外后，造影均未见血管损伤和血栓形成，无动脉瘤破裂出血。患者麻醉清醒后无神经功能缺损。术后3个月随访，MR血管成像证实相关血管通畅。结论手工制作微导丝套索装置处理动脉瘤栓塞过程中移位弹簧圈，是一种简单、有效、经济的方法。