前交通动脉瘤血管内栓塞治疗

目的总结以电解可脱性弹簧圈(GDC)血管内栓塞治疗前交通动脉瘤的技术要点、并发症及其防治经验,并评价其治疗效果.方法对46例前交通动脉瘤患者采用经皮股动脉穿刺行全脑选择性血管造影术,应用GDC进行动脉瘤囊内栓塞;术后早期处理出血并有效的对症治疗.结果成功栓塞46个动脉瘤,其中44例临床痊愈,2例死亡,死亡率4.3%.术中动脉瘤腔100%闭塞者41例,95%闭塞者3例,90%闭塞者2例.术中动脉瘤破裂1例,并发脑血栓1例,并发脑血管痉挛4例;术后无弹簧圈末端逸出,1例复发者经二次补充GDC栓塞而治愈.术后随访3～50个月均无再出血.结论对前交通动脉瘤采用GDC进行血管内囊内栓塞疗效可靠;早期诊断、早期治疗、正确处理术中并发症、提高栓塞技术及积极有效的术后处理是减少术后并发症、提高治愈率的重要方法.

Endovascular treatment of intracranial anterior communicating artery aneurysm with coils

Objective To summarize the techniques, managements a nd the complications of endovascular embolization on anterior communicating artery aneurysm with Guglielmi detachable coils (GDC), and to evaluate the effec t of treatment.Methods Forty-six cases were treated with GDC t o embolize the aneurismal sac via femoral artery approach. The hemorrhage wa s early removed from subarachnoid cavity after operation.Results Forty-six aneurysms were cured, forty-four patients recovered clinically, an d two patients died. The mortality was 4.3%. The 100% embolization was achi eved in the sacs of 41 aneurysms, 95% embolization in 3 ,and 90% embolization in 2 . One case of aneurysm reputured during the embolization. One case suf fered from cerebral embolism and four cases suffered from cerebral vasospasm. Th e microcoil had not escaped after operation. One recurring case was cured by sec ond GDC embolization. No rebleeding occurred in the 3 to 50 months' follow- up.Conclusion GDC occlusion is a safe and effective treatme nt for the anterior communicating artery aneurysm. Advances in the techniques an d correct treatment of the complications will decrease the complications and imp rove future outcome.