手术治疗栓塞失败的颅内动脉瘤

目的总结用开颅手术方法治疗栓塞失败的颅内动脉瘤的经验.方法 1999年2月至2002年4月采用手术方法治疗栓塞失败的颅内动脉瘤8例(男性5例,女性3例),其中后交通动脉瘤3例,前交通动脉瘤2例,大脑前动脉A1段动脉瘤1例,大脑中动脉分叉部动脉瘤1例,小脑后下动脉动脉瘤1例.动脉瘤的直径平均为12 mm.结果 8例患者术后均恢复良好,脑血管造影复查,动脉瘤均完全消失,无动脉瘤残留.治疗期间均未发生动脉瘤再破裂出血,无手术合并症和术后死亡.结论栓塞治疗颅内动脉瘤应严格掌握适应证.有动脉瘤残留或再通者建议行显微手术治疗.

Surgical treatment of intracranial aneuysms following failed embolization

Objective To introduce and summarize the experience of surgical treatment of intracranial aneurysms in which embolization was of failure.Methods 8 cases of intracranial aneurysms (5 male, 3 female) with failed embolization, including 3 cases of posterior communicating artery aneurysms, 2 cases of anterior communicating aneurysms, one case of A 1 segment, one case of middle cerebral artery bifurcation aneurysms, one case of posterior inferior cerebellar artery aneurysm, were treated by microsurgical procedures between February 1999 and April 2002. The mean diameter was 12 mm.Results All cases were clipped successfully and the post-operative procedures were smooth. Post-operative digital subtraction angiography (DSA) demonstrated that all aneurysms disappeared and there was no residual aneurysm. There was no aneurysm re-bleeding, no surgical complication and no mortality.Conclusion Choice of embolization must be according to strict adaptions. If residual aneurysms or re-vascularizion happen, surgical clipping is recommended.