宽颈动脉瘤血管内辅助栓塞技术的介入治疗

目的探讨各种辅助栓塞技术在颅内宽颈动脉瘤介入治疗中的应用。方法运用各种辅助栓塞技术包括微导丝微导管辅助技术,双微导管技术,球囊再塑形技术及血管内支架载瘤动脉成形术,栓塞颅内宽颈动脉瘤73例,共89个动脉瘤,其中9个为非宽颈动脉瘤。结果完全栓塞或大部栓塞73个,瘤颈残留5个,动脉瘤及载瘤动脉闭塞2个,死亡3例。45例获得临床随访,1例右侧后交通动脉瘤栓塞术后1年余再次出血,因瘤颈复发行栓塞治疗后愈合可,其余病人未见复发。结论颅内宽颈动脉瘤处理困难,选择合适血管内辅助栓塞技术,有助于提高宽颈动脉瘤的治愈率。

Interventional therapy of wide-necked aneurysms with endovascular assisting techniques

Objective To explore the use of different assisting endovascular treatment of intracranial wide-necked aneurysms. Methods embolic techniques for Eighty-nine intracranial wide-necked aneurysms in 73 cases were treated with microwire and microcatheter assisting technique, double microcatheters technique, balloon remodeling technique and stent endovascularplasty technique. Results Completely or nearly occlusion achieved in 73 aneurysms, five aneurysms have dog-ears, two aneurysms and the parent arteries were occluded and three patients died. Forty-five cases were followed up. One patient with the right posterior communicating aneurysm embolized one year later were embolized once again because of the recurrence of the neck and the rebleeding. No recurrence in others occured. Conclusions It is troublesome to deal with the intracranial wide-necked aneurysms. Suitable assisting embolic techniques can help to enhance the healing rate of the wide-necked intracranial aneurysms.