颅内宽颈动脉瘤的血管内治疗33例分析

目的总结应用颅内支架或球囊辅助技术治疗颅内宽颈动脉瘤的体会。方法应用颅内支架或球囊辅助瘤颈成形术结合Microplex弹簧圈栓塞治疗颅内破裂宽颈动脉瘤33例。动脉瘤位于前交通动脉8例，后交通动脉19例，大脑中动脉3例，基底动脉顶端3例。结果以支架辅助治疗的19例动脉瘤中13例完全致密填塞，4例填塞90％以上，2例大部填塞（70％～90％）。以球囊辅助治疗的14例动脉瘤中9例完全致密填塞，3例填塞90％以上，2例大部填塞。结论支架或球囊辅助治疗颅内宽颈动脉瘤是安全、有效的方法，两种方法各有优缺点，应根据动脉瘤的具体情况来选择采用支架或球囊治疗。

Endovascular therapy for intracranial wide-necked aneurysms

Objective To summarize the clinical experience of intracranial wide-necked aneurysms using intracranial stent technique or balloon-assisted technique. Methods Thirty-three ruptured intracranial wide-necked aneurysms were treated by stent-assisted or balloon-assisted technique combined with the use of Microplex coils. The lesions included 8 anterior communicating artery aneurysms, 19 posterior communicating artery aneurysms, 3 middle cerebral artery aneurysms and 3 basilar artery aneurysms. Results Of 19 patients treated with stent-assisted technique and Microplex coils, complete occlusion of the aneurysm was achieved in 13, over 90% occlusion in 4 and (70-90) % occlusion in 2. Among another 14 patients treated with balloon-assisted technique and Microplex coils, complete occlusion of the aneurysm was achieved in 9, over 90% occlusion in 3 and (70-90) % occlusion in 2. Conclusion For the treatment of intracranial wide-necked aneurysms, both the stent-assisted and balloon-assisted techniques are safe and effective. In treating intracranial wide-necked aneurysm, the selection of proper technique should be based on the patient's individual condition.