| 颅内破裂微小动脉瘤血管内治疗的安全性和有效性 |
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| 引用本文： | 丰,涛,赵,瑞,许,奕,洪,波,黄清海,刘建民.颅内破裂微小动脉瘤血管内治疗的安全性和有效性[J].中国临床神经外科杂志,2020,0(5):257-260. |
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| 作者姓名： | 丰 涛 赵 瑞 许 奕 洪 波 黄清海 刘建民 |
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| 作者单位： | 200433 上海，海军军医大学附属长海医院神经外科（丰 涛（现在山东省单县中心医院工作）、赵 瑞、许 奕、洪 波、黄清海、刘建民） |
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| 基金项目： | 国家重点研发计划资助(2016YFC1300700);国家卫生计生委脑卒中防治工程“中国脑卒中高危人群干预适宜技术研究及推广项目”(GN-2016R0012)。 |
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| 摘 要： | 目的探讨颅内破裂微小动脉瘤血管内治疗的安全性及有效性。方法回顾性分析2016年1月至2017年12月收治的53例颅内破裂微小动脉瘤的临床及随访资料,均采用血管内治疗。结果动脉瘤最大直径平均(2.19±0.55)mm。单纯弹簧圈栓塞27例,球囊辅助栓塞2例,支架辅助栓塞24例;术后即刻造影显示动脉瘤致密栓塞24例(45.3%),瘤颈残留16例(30.2%),瘤体显影13例(24.5%)。共3例(5.7%)发生围术期并发症,其中1例(1.9%)为术中破裂,1例(1.9%)为术中血栓形成,1例(1.9%)为术后早期再出血。39例影像学随访3·13个月,平均平均(6.1±2.4)个月,动脉瘤不显影32例(82.1%);稳定3例(7.7%);复发4例(10.3%),均再治疗。51例临床随访6~28个月,平均(14.9±6.6)个月,改良Rankin量表评分0~2分50例(98.0%),3分1例(2.0%)。结论对于颅内破裂微小动脉瘤,血管内治疗具有较高的围手术期安全性,以及较高的短期治愈率和临床预后良好率。
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| 关 键 词： | 颅内破裂微小动脉瘤 血管内治疗 安全性 有效性 |
Safety and efficacy of endovascular treatment for ruptured tiny intracranial aneurysms (report of 53 cases) |
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| FENG Tao,ZHAO Rui,XU Yi,HONG Bo,HUANG Qing-Hai,LIU Jian-Min..Safety and efficacy of endovascular treatment for ruptured tiny intracranial aneurysms (report of 53 cases)[J].Chinese Journal of Clinical Neurosurgery,2020,0(5):257-260. |
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| Authors: | FENG Tao ZHAO Rui XU Yi HONG Bo HUANG Qing-Hai LIU Jian-Min |
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| Affiliation: | Department of Neurosurgery, Changhai Hospital, Naval Medical University, PLA, Shanghai 200433, China |
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| Abstract: | Objective To assess the safety and short-term efficacy of endovascular treatment for ruptured tiny intracranial aneurysms. Methods The clinical and follow-up data of 53 patients with ruptured tiny intracranial aneurysms who were treated with endovascular treatment from Januray, 2016 to December, 2017 were retrospectively reviewed. Results The mean aneurysms size was (2.19±0.55) mm. Of these 53 patients, 27 patients were treated with simple coil embolization, 2 with balloon-assisted coiling and 24 with stent-assisted coiling. Immediate angiographic results showed that Raymond grade Ⅰ occlusion of aneurysm was achieved in 24 (45.3%) patients, grade Ⅱ in 16, grade Ⅲ in 13. Periprocedural complications occurred in 3 (5.7%) patients: intraprocedural aneurysm rupture in 1(1.9%), intraprocedural thrombosis in 1 (1.9%) and postoperative aneurysm rebleeding in 1 (1.9%). Angiographic follow-up of 39 patients ( mean, 6.1 months) showed that complete occlusion of aneurysm was achieved in 32 (82.1%) patients, stabilization in 3 (7.7%) patients, recurrence in 4 (10.3%) patients receiving retreatment. Clinical follow-up of 51 patients (mean, 14.9 months) showed that 50 (98.0%) patients had a favorable neurological outcome (mRS score of 0~2) and 1 (2.0%) had a poor neurological outcome (mRS score of 3). Conclusions Endovascular treatment of ruptured tiny intracranial aneurysms is safe and effective, with high rates of complete occlusion of aneurysm and favorable neurological outcomes at follow up |
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| Keywords: | Ruptured tiny intracranial aneurysms Endovascular treatment Safety Efficacy |
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