颅内动脉瘤血管内治疗中复杂情况的处理

目的：探讨l5例在血管内治疗中发生的复杂问题的颅内动脉瘤的处理。方法：窄颈动脉瘤直接采用GDC栓塞治疗、宽颈动脉瘤先用支架成形后再应用GDC栓塞治疗、巨大动脉瘤及假性动脉瘤采用可脱式球囊或弹簧圈闭塞载瘤动脉。结果：3例窄颈动脉瘤采用GDC栓塞治疗中动脉瘤破裂出血，经继续栓塞后全部治愈；3例宽颈动脉瘤采用支架成形后应用GDC栓塞治愈；9例巨大动脉瘤及假性动脉瘤采用可脱式球囊或弹簧圈闭塞载瘤动脉后，8例治愈，l例因严重贫血发生脑梗塞而遗留轻度神经功能缺失。结论：采用GDC或微支架辅助GDC血管内栓塞是治疗动脉瘤的一种微创、安全、有效的方法，贫血在行载瘤动脉闭塞时确定脑血流代偿能力的诸因素中具有重要意义。

The management of complex condition during endovascular treatment for intracranial aneurysms

Objective:To discuss the management of comple x condition in 15 cases during endovascular treatment for intracranial aneurysms Methods: Narrow necked aneurysms were embolized with GDC dire ctly, wide necked aneurysms were remodeled with stent, then were embolized with GDC In giant and false aneurysms the parent artery was embolized with detacha ble balloon or coil Results: 3 aneurysms in 3 cases were broken during embolization with GDC,but all were cured by continue embolization 3 c ases of wide necked aneurysms were cured by stenting combining with GDC Among 9 cases of giant and false aneurysms, 8 of them were cured but brain infarction occurred in 1 case because of anaemia Conclusion: Endovascu lar embolization with GDC or GDC combining with stent is a minimal traumatic, secure and effective method of treatment for intracranial aneurysms Of all the factors that can estimate the compensative capability of cerebral blood flow, a nemia were very important while deciding to embolize the parent artery