前交通动脉瘤的栓塞和手术治疗

目的 探讨前交通动脉瘤栓塞和手术的风险、难度及其适应证.方法 186例前交通动脉瘤患者,治疗前分析开颅夹闭和栓寒的风险及难度,并结合患者及家属意见确定治疗方案.经翼点入路开颅夹闭58例,经颅-眶入路夹闭8例,经血管内弹簧圈栓塞120例.结果 开颅手术组术后肢体活动障碍2例,死亡3例.弹簧圈栓塞组术后肢体活动障碍2例,死亡3例,再出血1例.结论 不同患者栓塞和手术夹闭风险各异,术前风险评估是确定治疗方案的重要依据.

Coiling and clipping treatment for anterior communicating artery aneurysms

Objective To evaluate the risk, difficulty and indication of clipping and coiling for anterior communicating artery aneurysms (AcomA). Method 186 patients with AcomA were treated. We chose the treatments options according the risk and difficulty. Fifty-eight cases were treated with clipping through pterional approach,8 through orbitocranial approach and 120 with coil embolization. Results Of the 66 patients with clipping,2 were left with procedure-related hemiparalysis and 3 died. Of the 120 patients with coil cmbolization, 2 were left with procedure-related neurological deficits, 3 died and 1 rebleeding. Conclusions There is different risk and difficulty in different cases with different therapy. The evaluation of the risk is important basis for decision of treatment option.