血管内栓塞治疗颅内破裂动脉瘤的随访研究

目的总结颅内破裂动脉瘤栓塞治疗后再出血、再通的发生率并分析影响因素。方法采用弹簧圈栓塞治疗颅内破裂动脉瘤304例,其中单纯弹簧圈栓塞179例,球囊辅助101例,支架辅助24例;并进行随访。结果完全栓塞214例(70.4%),次全栓塞76例(25.0%),不全栓塞14例(4.6%)。其中GOS评分:恢复良好257例,轻度残疾23例,重度残疾10例,死亡14例。临床随访236例,平均时间26个月,发生再出血5例;其中DSA随访205例,平均5个月,发生再通37例,其中再治疗17例。随访显示:栓塞程度影响动脉瘤术后再通率,差异具有统计学意义(P0.05)。结论颅内破裂动脉瘤弹簧圈栓塞治疗后,再出血发生率低,不全栓塞是破裂动脉瘤治疗后再出血、再通的危险因素。

The follow-up analysis on endovascular embolization of ruptured intracranial aneurysms

Objective To investigate the incidences of rebleeding and recanalization in ruptured intracranial aneurysms after embolization and analyze the influence factors.Methods Three hundred and four patients with ruptured intracranial saccular aneurysms were treated by detachable coilembolization,including179 by simple detachable coilembolization alone,101assistedwithballoon,and24assistedwithstent.A follow-up was performed.Results Complete embolization was achieved in 214 patients （70.4%）,incomplete in 76 （25%） and partial in 14 （4.6%）.GOS score revealed recovered well in 257 patients,minor disabled in 23,severe disabled in 10.Clinical follow-up was performed in 236 patients with a mean of 26 months and rebleeding occurred in 5 patients.Among them,205 cases were reexamined by DSA with a mean of 5 months including recanalization occurred in 37 cases and retreatment was performed in 17,indicating the degree of embolization could affect incidence of recanalization （P0.05）.Conclusions Rebleeding rate is low in the intracranial ruptured aneurysms embolized with detachable coils.Incomplete embolization may increase the risk of rebleeding and recanalization after treatment of ruptured aneurysms.