126例前交通动脉瘤的介入治疗

目的：探讨前交通动脉瘤介入治疗的特点,以提高临床疗效。方法：经血管内途径,采用可脱性弹簧圈对126例前交通动脉瘤患者行栓塞治疗,未能栓塞者多数行手术治疗。结果：成功栓塞109例,其中100％闭塞97例,95％－98％闭塞12例。17例栓塞未成功者,行外科手术治疗15例,2例因脑血管痉挛而未进行处理。123例患者治疗后痊愈;1例死亡;2例栓塞失败后未进行治疗的患者,分别随访5个月及1年,动脉瘤自愈。本组32例治疗后获随访3周－30个月,行脑血管造影,30例动脉瘤未见显影;2例复发,经再次栓塞后治愈。结论：多数前交通动脉瘤可经血管内栓塞治愈,不能行血管内治疗的可行外科手术治疗,极少数病例可自愈,但远期效果仍需行长期随访观察。

Interventional treatment of 126 patients with anterior communicating artery aneurysm

Objectives To analyse the characteristics of interventioal treatment for anterior communicating artery aneurysm (AcoAA) and improve curative effects. Methods In 126 patients, detachable microcoils were used to embolize the AcoAA via endovascular approach. Those patients failed to be embolized were treated by surgical clipping. Results Of the 109 patients who were embolized successfully, 97 were achieved 100% occlusion, 12 95%-98% occlusion. In the other 17 patients who failed to interventional treatment 15 were treated surgically and 2 no treatment beacuse of cerebral vascular spasm. 123 patients were cured, one died, and 2 had aneurysms disappearred without any operations, as proved by follow up for 5 months to 1 years. Of 32 patients checked by cerebral angiography 3 weeks to 30 months after operation, 30 showed disappeared of aneurysms and 2 had recurrence. The recurred aneurysms were successfully reembolized. Conclusions Most of AcoAAs can be cured by endovascular interventional treatment. Those who failed to be treated by embolization can be cured surgically. Few patients may be healed spontaneously. The long term effects of treatment should be followed up for a long time.