电解可脱弹簧圈栓塞治疗颅内破裂动脉瘤203例

摘要

目的：总结血管内栓塞治疗颅内破裂动脉瘤的经验体会，探讨其适应证、技术要点及并发症的防治。方法回顾性分析应用血管内栓塞治疗的203例颅内破裂动脉瘤患者的临床资料及随访结果。应用电解脱弹簧圈直接栓塞162例，支架辅助31例，双导管技术2例，球囊辅助3例。结果203例中198例成功栓塞。术后即刻DSA造影结果按Raymond分级：I级121例，II级56例，III级21例。出院时恢复良好无神经功能障碍169例，轻度神经功能障碍16例，重度障碍8例，死亡5例。全部病例随访3～36个月，均病情稳定，无新发神经功能障碍及再出血病例。结论血管内栓塞是治疗颅内破裂动脉瘤的一种微创、相对安全有效的治疗方法。%Objective To summarize the experience of endovascular treatment of ruptured intracranial aneurysms and discuss the indications,technique and complications of embolization.Methods The clinical records of 203 patients with ruptured intracranial aneurysms treated by endovascular embolization were reviewed.Results Of 203 patients,198 were embolized successfully using only Guglielmi detachable coils(162)and additional stent assist(31),double microcatheters(2)and balloon remodeling technique (3).Immediate occlusion of the aneurysm was achieved in 121(Raymond grade I),56(grade II)and 21(grade III).Of 198 patients, 169 recovered well,16 had mild and 8 severe disability.5 patients died after the embolization.All 193 surviving patients were in stable condition without new neurological dysfunction or re-bleeding within the 3-36 month follow-up.Conclusions Endovascular embolization is a relatively safe and effective minimally invasive treatment method for ruptured intracranial aneurysms.