球囊辅助弹簧圈栓塞治疗大脑中动脉动脉瘤

目的探讨应用球囊辅助弹簧圈栓塞治疗大脑中动脉动脉瘤的可行性、安全性、有效性及操作技巧。方法采用球囊辅助弹簧栓塞治疗25例大脑中动脉动脉瘤,其中动脉瘤位于大脑中动脉M1段末端5例,M2段4例,均应用HyperGlide球囊辅助栓塞;动脉瘤位于大脑中动脉分叉部16例,其中5例应用HyperGlide球囊辅助栓塞,11例应用HyperForm球囊辅助栓塞。结果 1例近全栓塞,其余患者均获100%栓塞,术中出现1例球囊回抽困难,术后3例患者出现脑缺血症状,2例经治疗完全缓解,1例残存不完全性失语。所有患者均随访无再出血。结论球囊辅助弹簧圈栓塞技术是治疗大脑中动脉动脉瘤的一种安全有效的方法,可增加动脉瘤的致密栓塞率,并有效减少并发症的发生。

Balloon-assisted endovascular embolization of middle cerebral artery aneurysms with microcoils(a report of 25 cases)

Objective To discuss the feasibility,safety,effectiveness and technique of balloon-assisted endovascular treatment of middle cerebral artery（MCA） aneurysms with microcoils. Methods The clinical data of 25 patients with MCA aneurysms,who were treated by balloon-assisted endovascular embolization with microcoils,were analyzed retrospectively,including aneurysmal location and morphology,width of aneurysmal necks,vasospasm or not,endovascular technique and so on. Results Of 25 patients with MCA aneurysms,24 received totally occlusion of the aneurysms and 1 subtotal. The postoperative cerebral ischemia occurred in 3 patients,of whom,2 were recovered from the cerebral ischemia after antivasospastic treatment and 1 suffered from local cerebral infarct and anepia. Rebleeding did not recurred in all the patients. Conclusion Balloon-assisted endovascular embolization with microcoils is a safe and effective method to treat MCA aneurysms,can enhance dense-packing rate of MCA aneurysms,and reduces the postoperative complications.