颅内动脉瘤显微手术夹闭栓塞治疗后再破裂(附2例报告)

目的 探讨颅内动脉瘤栓塞后复发的原因、处理措施。方法 对2例自发性蛛网膜下腔出血病人行血管造影及栓塞治疗，动脉瘤再破裂出血后行显微外科手术治疗。结果 2例病人经血管造影证实均为后交通动脉瘤，用GDC行栓塞治疗，分别在栓塞后7个月、21个月再次发生蛛网膜下腔出血，血管造影检查及手术发现为动脉瘤复发并破裂，即行显微手术夹闭动脉瘤。结论 颅内动脉瘤血管内栓塞治疗后再复发的主要原因有：栓塞不致密或栓塞不全，以及血流动力学的影响。对再破裂动脉瘤宜行手术予以夹闭。

Microsurgical surgical clipping of post embolization reruptured intracranial aneurysms(report of 2 cases)

Objective To explore the causes and managements of recurrent intracranial aneurysms after endovascular embolization. Methods 2 cases of spontaneous subarachnoid hemorrhage with previously DSA diagnosed and endovascular embolized aneurysms were admitted. The recurrent and re-hemorrhaged aneurysms were all clipped by microsurgical operations. Results 2 patients' posterior communicating artery aneurysms that had been embolized by GDC before the re-hemorrhage which suffered from spontaneous subarachnoid re-hemorrhage 2 months, 21 months after embolization respectively were proved by DSA. DSA and surgery proved the aneurysm to be recurrence and rerupture. The aneurysms were completely clipped by aneurysm clips. Conclusion The recurrent causes of intracranial aneurysms post embolization is due to loose or incomplete embolization and blood flow influence. The reruptured aneurysms after embolization should be clipped by microsurgical operation.