弹簧圈栓塞颅内破裂微小动脉瘤的疗效观察

目的探讨血管内介入栓塞治疗颅内破裂微小动脉瘤的可行性及疗效。方法回顾性分析11例颅内破裂微小动脉瘤患者的临床资料。均由CT证实为蛛网膜下腔出血,并经DSA证实后实施了微弹簧圈栓塞治疗。结果①本组有前交通动脉动脉瘤9例,脉络膜前动脉瘤1例,胼周动脉瘤1例。入院时Hunt-Hess分级Ⅰ级3例,Ⅱ级5例,Ⅲ级2例,Ⅳ级1例。②11例均被栓塞成功,其中被完全栓塞6例,次全栓塞5例,在术后3～6个月的DSA随访中,显示这5例完全闭塞。术后格拉斯哥预后评分（GOS）5分的有9例,4分的有1例,死亡1例。无技术相关并发症。③术后3～6个月DSA随访6例,MRA随访2例,电话随访2例。有影像资料的随访病例显示,动脉瘤均被完全闭塞;电话随访患者GOS均为5分,无再出血。结论微弹簧圈栓塞颅内前循环微小动脉瘤安全、可行,短期随访结果显示效果良好。

Clinical observation of coil embolization of ruptured tiny intracranial aneurysms

Objective To investigate the feasibility and efficacy of endovascular embolization of ruptured tiny intracranial aneurysms.Methods The clinical data of 11 patients with ruptured tiny intracranial aneurysm were analyzed retrospectively.All the patients with subarachnoid hemorrhage(SAH) were diagnosed by CT and microcoil embolization was performed after being confirmed by digital subtraction angiography(DSA).Results ①Nine patients had anterior communicating artery aneurysm,1 had anterior choroidal artery aneurysm,and 1 had pericallosal artery aneurysm.At admission,the Hunt-hess grade Ⅰ was 3 cases,grade Ⅱ was 5,grade Ⅲ was 2,and grade Ⅳ was 1.②All the patients were embolized successfully,6 of them were embolized completely,and 5 were embolized incompletely(during 3 to 6 months DSA follow-up,they were all obliterated completely).The GOS were 5 in 9 patients,GOS 4 in 1 patient,and 1 patient died after the procedure.No technology-related complications were observed.③At 3 to 6 months after procedure,6,2,and 2 patients were followed up with DSA,magnetic resonance angiography(MRA) or telephone respectively.The aneurysms were all obliterated completely,the GOS were 5 in all patients,and no rebleeding occurred.Conclusion Endovascular embolization of ruptured tiny intracranial aneurysms in intracranial anterior circulation is safe and feasible,and the result of short-term follow-up is good.