颅内大脑中动脉动脉瘤的介入栓塞治疗

目的 探讨颅内大脑中动脉动脉瘤的介入栓塞疗的可行性.方法 对2002年1月至2007年12月共介入治疗颅内大脑中动脉动脉瘤62例患者,共计64个动脉瘤,进行致残率和致死率的统计并行6个月的随访研究.结果 经6个月以上的随访,62例患者无一例死亡;有1例再出血,经开颅血肿清除动脉瘤夹闭后转当地医院治疗,出院时意识不清;12例患者在治疗后一过性出现神经定位体征,肢体瘫痪,感觉障碍,失语等,经抗凝,扩容治疗后恢复;1例出现上肢永久性活动障碍6个月后肌力Ⅲ级.这组病例取得了良好的治疗效果.结论 在大脑中动脉动脉瘤病例中实施介入栓塞治疗是一种安全有效的治疗方法.

Endovascular treatment of middle cerebral artery aneurysms with detachable coils

Objective To analyze the feasibility, safety, and efficacy of coil embolization in a consecutive series of MCA (middle cerebral artery) aneurysms chosen for endovascular treatment. Method Sixty-two patients harboring Sixty-four MCA aneurysms were primarily selected for coil embolization in our institution between January 2002 and December 2007. All patients had an acute subarachnoid hemorrhage(SAH). SAH was classified according to Hunt and Hess grade :Ⅰ(33) ,Ⅱ(24), Ⅲ(5).Results Sixty-four MCA aneurysms (59 ruptured, 5 unruptured) were occluded with coils in 62 patients. Thromboembolic events occurred in 12 (19. 4%) in 64 procedures. Endovascular treatment was performed without complications for 48 (81.2%) of the treated aneurysms. The treatment-related mortality rate was 0% and the treatment-induced permanent morbidity rate was 1.6% (one patient).Conclusions Endovascular coil embolization can be performed safely and effectively in selected MCA aneurysms.