颅内动脉瘤的介入栓塞治疗56例临床分析

目的探讨电解可脱性弹簧圈介入栓塞治疗急性破裂性颅内动脉瘤的并发症及其防治。方法在数字减影全脑血管造影（DSA）监视下,经股动脉,采用电解可脱性弹簧圈（GDC）栓塞治疗56例急性破裂性颅内动脉瘤患者。结果成功栓塞达100%有51例（92%）,栓塞达90%以上4例（7%）,栓塞达90%以下1例（1%）。全组手术死亡2例（3.57%）;术中动脉瘤再破裂出血2例,载瘤动脉痉挛2例,GDC外逸3例,血栓形成2例,过度栓塞2例,术后并发高血压脑出血1例,并发症发生率19.6%,成功率80.23%。结论采用电解可脱式铂金螺旋圈（GDC）或微支架辅助GDC血管内栓塞是治疗颅内动脉瘤的一种微创、安全、有效的方法。在于术者对颅内动脉瘤和载瘤动脉解剖关系的正确认识,介入操作技术、术中、术后发生并发症的正确处理,栓塞材料的改进。

Clinical analysis of fifty-six cases of intervention embolization treatment to intracranial aneurysm

Objective To explore the complications and countermeasures in acute rupture intracranial aneurysm embolization with Guglielmi Detachable Coil （ GDC） . Methods 56 patients with acute rupture intracranial aneurysm were embolized with GDC under the digital subtraction angiography （ DSA） imaging. Results Total occlusion was achieved in 51 cases （ 92 % ） ,over 90 % in 4 cases （ 7 % ） ,less than 90 % in one cases （ 1 % ） . 2 patients died （ 3. 57 % ） ; the parent artery were constricted in 2 cases; GDC escaped in 3 cases,2 had over embolizations,2 had thromboses; and 1 had hypertension hemorrhage after surgery. The rate of complications was 19. 6% ,and success rate was 80. 23% . Conclusion Endovascular embolization with Guglielmi detachable coil （ GDC） or GDC combining with stent is a minimal traumatic,secure and effective method of treatment for intracranial aneurysms. More knowledge of intracranial aneurysm and its parent artery angioanatomy,better skill in embolization technique,correct judgment during treatment and improved embolic material are helpful to reduce the complications.