血管内介入治疗颅内微小动脉瘤

目的:评价介入治疗颅内微小动脉瘤的临床效果,选择有效的手术方式。方法:回顾性分析栓塞治疗25例颅内微小动脉瘤(直径小于3.0mm)的手术方式及效果。均在全麻下行介入治疗。术后即刻血管造影:16例单纯弹簧圈栓塞中14例100%填塞,2例95%填塞;6例支架辅助弹簧圈栓塞中4例100%填塞,2例95%填塞。3例单纯支架覆盖瘤颈造影剂滞留加重。结果:单纯弹簧圈栓塞中10例复查,8例100%填塞,2例50%填塞;支架辅助弹簧圈栓塞4例复查,全部100%填塞。2例单纯支架覆盖瘤颈复查动脉瘤均不显影。结论:对颅内微小动脉瘤采取单纯使用弹簧圈或结合颅内支架栓塞是较好的治疗方法,治疗关键是治疗方法的选择和微导管的操作技术。

Endovascular treatment of micro-intracranial aneurysms

Objective:To assess the effect of micro-intracranial aneurysms using endovascular embolization and choose the effective treament.Mehtods:Embolotherapy and the effect of 25 patients with 25 micro-intracranial aneurysms that the diameter smaller than 3 millimeters(<3mm)was analyzed retrospectively.Angiography was performed after embolism immediately.Among 16 aneurysms embolized only with coil,14 aneurysms were embolized 100% and 2 aneurysms were embolization 95%.Among 6 aneurysms embolized with neuroform stent combined with coil,4 aneurysms were 100% embolized and 2 aneurysms 95%.Contrast agent stagnation was found in aneurysm cavity in 2 aneurysms that the neck was covered with neuroform stent only.Results:Angiographic follow-up studies show:in 10 patients the aneurysms were embolized only with coil,8 aneurysms completely occluded,and 2 aneurysms had partial coiling(50% occlusion).In 4 patients the aneurysms were embolized with neuroform stent combined with coil,4 aneurysms were 100% embolized.The aneurysms in two patients could not be seen on screening,which only the neck was covered with neuroform stent.Conclusion:Endovascular treatment of micro-intracranial aneurysms using coil only or neuroform stent combined with coil was a safe and effective method.The key was the choice of treaments method and the skill of application of microcatheter.