破裂颅内动脉瘤的血管内治疗

目的分析总结破裂的颅内动脉瘤血管内治疗的效果及特点。方法24例患者术前头部CT或MRI检查均为自发性蛛网膜下腔出血，DSA检查确诊为颅内动脉瘤，共28个，其中1例患者有3个动脉瘤，2例患者各有2个动脉瘤。动脉瘤直径2～5mm10个，6-15mm16个，16～25mm2个。Hunt～Hess分级Ⅰ级5例，Ⅱ级8例，Ⅲ级8例，Ⅳ级2例，Ⅴ级1例。24例动脉瘤均采用血管内栓塞治疗，其中1例患者的3个动脉瘤栓塞了2个，另1个行手术夹闭。结果临床治愈21例，偏瘫1例，死亡2例。术后随访3-24个月，存活22例均恢复良好，无再出血发生。结论血管内栓塞治疗颅内动脉瘤效果满意，并发症少，残死率低。

Endovascular Treatment of Ruptured Intracranial Aneurysms(a Report of 24 Cases)

Objective To explore the curative effect of endovascular treatment on ruptured intracranial aneurysms and its technique. Methods Twenty-four patients with spontaneous subarachnoid hemorrhage confirmed by CT or MRI underwent the DSA examination, which showed that the diameters of intracranial aneurysms ranged from 2 mm to 5 mm in 10 aneurysms, did from 6 mm to 15 mm in 16 ones and did from 16 mm to 25 mm in 2 ones. There were 28 aneurysms in 24 patients. There were 3 aneurysms in 1 patients and there were 2 aneurysms in each of 2 patients. According to Hunt-Hess grading, of 24 patients, 5 belonged in grade Ⅰ , 8 in grade Ⅱ, 8 in grade Ⅲ, 2 in grade Ⅳ and 1 in grade Ⅴ. The aneurysms were embolized with Guglielmi detachable coils （GDC） in 24 patients. Two aneurysms were endovascularly embolizated and 1 aneurysms were clipped in the patients with 3 aneurysms. Results Of 24 patients with intracranial aneurysms, 21 were clinically cured, 1 was disabled （hemiplegia） and 2 died. The following-up from 3 to 24 months showed that 22 survival patients were recovered well, and did not suffered from re-bleeding. Condusions Endovascular embolization by GDC is safe and effective treatment in patients with ruptured intracranial aneurysms, in whom there are few complications, and low disabled and death rates after undergoing endovascular embolization.