颅内动脉瘤在栓塞治疗中不全栓塞的原因和预防措施

目的探讨颅内动脉瘤不全栓塞的原因及预防措施。方法采用经股动脉插管行全脑血管造影,应用电解脱微弹簧圈进行动脉瘤栓塞。共45例47个动脉瘤,其中前交通动脉瘤19个,大脑中动脉分叉处动脉瘤7个,后交通动脉瘤16个,颈内动脉动脉瘤5个,2例同时存在2个动脉瘤。结果完全致密填塞(动脉瘤体积100%不显影)35个;不全栓塞动脉瘤12个,其中95%不显影9个,90%不显影2个,80%不显影1个。结论颅内宽颈动脉瘤、大动脉瘤以及蛇形、不规则分叶状动脉瘤不全栓塞率较高,采用筐篮技术,球囊辅助技术,血管重建术和蚕食样分步栓塞术以及应用新型栓塞材料GDC-M atrix可降低不全栓塞率。

Causes and Protection of Intracranial Aneurysms Uncompletely Embolized with Micro-coils

Objective To study the causes and protection of intracranial aneurysms uncompletely embolized with micro-coils. Methods 47 cases of intracranial aneurysms were treated with micro-coils to embolize the aneurysaml sac via femoral artery approach to endovascular embolization.The aneurysms were located on AcoA in 19,on MCA in 7,on PcoA in 16 and on ICA in 5,2 aneurysms were foundin each of 2 cases. Results The uncompletely occuluded in 12 of them,aneurysms were completely occluded in 35,9 aneurysms wereoccluded to 95%,2 aneurysms were occluded to 90%,1 neurysms were occluded to 80%. Conclusion The wide neck intracranialaneurysms,hugeness intracranial aneurysms and ophidian,irregular intracranial aneurysms are of high rate of uncompletely occluded.Usingbasket-technique,remodel technique,vein rebuild technique and nibble subdivision endovascular embolization can decrease the rate ofuncompletely embolize intracranial aneurysm.