血管内栓塞治疗颅内动脉瘤

目的 总结血管内栓塞治疗颅内动脉瘤经验。方法 股动脉Seldinger穿刺，先后应用MagicBD,Tracker-16,Tracker-10和Cordis 3F/2.5F微导管，送入球囊、不同长度的国产、进口游离微弹簧圈，配用MDS、GDC系统送入不同长度微弹簧圈、治疗颅内动脉海绵窦段动脉瘤5例、后交通动脉瘤1例、颈内动脉C2段动脉瘤3例、椎动脉颅内段动脉瘤3例、大脑后动脉瘤P2段动脉瘤1例，治疗颅内动脉C3－4段假性动脉瘤5例。结果 本组无1例死亡。球囊闭塞颈内动脉海绵窦段动脉瘤5例均痊愈，无并发症；微弹簧圈栓塞治疗动脉瘤栓塞达100％者9例、95％者2例，其中1例因血管痉挛遗留轻瘫，1例因MDS到位后不能顺利解脱导致部分脱垂于颈内动脉和大脑中动脉2cm,遗留轻瘫；5例假性动脉瘤完全治愈；闭塞载瘤动脉及动脉瘤的2例椎动脉完全治愈。结论 颈内动脉海绵窦段动脉瘤只要前、后交通动脉侧支循环代偿良好，可脱球囊闭塞载瘤动脉是安全有效的。微弹簧圈栓塞治疗颅内动脉瘤是一种有发展前途的治疗方法。

Endovascular treatment of intracranial aneurysm

Objective To setup an endovascular treatment of intracranial aneurysm with detachable baloon and microcoil. Methods Transfemoral artery Seldinger's catheterization was used. Baloons and free MDS, GDC microcoils were pushed into the aneurysm or carrying arteries. Results No mortality occurred in our group. Internal carotid arteries (ICA) were occluded with detachable baloons in 5 aneurysms at sinus segment of ICA and 4 traumatic pseudoaneurysms. No complications occurred. 9 aneurysms were completely occluded with microcoils and 2 were partly (95%) occluded. 2 patients got mild paralysis due to vasospasm or maldetaching of MDS coils.Conclusions Baloon occlusion of ICA for treatment of aneurysm at sinus segment is safe and effective in case of having abundant collateral circulation. Coil occlusion of intracranial aneurysm is a promising method of endovascular treatment. Compared with MDS, GDC coil is safer but expensive. Free coil is not very safe theoretically, but can be used with careful consideration as it is much cheaper.