一期血管内栓塞治疗颅内多发动脉瘤的临床研究

摘要

目的 总结和探讨一期血管内栓塞治疗颅内多发动脉瘤的方法及疗效.方法 对2005年9月-2010年6月收治的18例颅内多发动脉瘤患者的44个动脉瘤行一期血管内栓塞治疗,其中采用单纯弹簧圈栓塞动脉瘤32个,颅内支架(LEO支架或En-terprise支架)辅助弹簧圈栓塞宽颈动脉瘤12个.术后3～12个月进行临床和影像学随访.结果 全部病例栓塞成功.12枚支架到位满意.38个动脉瘤完全闭塞,5个闭塞95%以上,1个闭塞95%以下.无手术并发症,术后患者均恢复良好,临床随访3～12个月无动脉瘤再出血或脑血栓形成,其中数字减影血管造影(DSA)随访9例无动脉瘤复发及支架狭窄.结论 一期血管内栓塞是治疗颅内多发动脉瘤安全有效的方法,但其长期疗效仍需进一步观察.%Objective To preliminarily investigate and summarize the technique and efficacy of one-stage endovascular embolization for treatment of multiple intracranial aneurvsms. Methods Eighteen patients with multiple intracranial aneurvsms, in whom 44 aneurysms were found, were treated by endovascular embolization in one-stage from Sep. 2005 to Jun. 2009. Thirty-two aneurysms were embolized with hydro-detachable coils, and twelye wide-necked aneurvsms were embolized with intracranial stents (LEO stent or Enterprise stent)combined with hydro-detachable coils. The clinical and radiological follow-up period was 3 - 12 months after surgery. Results Embolization was successful in all patients, and the stent placement was optimal in 12. The total occlusion of aneurysmal cavities was achieved in 38 aneurysm, more than 95 ％ of the aneurysmal cavities were occluded in 5 aneurysms and less than 95％ in 1 aneurvsm. No operative complication was found and all the patients recovered well. No rebleeding or cerebral thrombosis occurred during the period of 3-12 months clinical follow-up, and no aneurysmal recurrence or in-stent stenosis was found in 9 patients followed-up by digital substraction angiography (DSA) . Conclusion Endovascular embolization in one-stage is a safe and effective technique for the treatment of multiple intracranial aneurysms, and the long-term efficacy still needs further observation.