颅内动脉瘤的介入治疗及随访
Research of interventional treatment and follow-up for intracranial aneurysms
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摘要: 目的: 探讨血管内栓塞治疗颅内动脉瘤的适应证和效果。方法: 对经血管内栓塞治疗及DSA复查的颅内动脉瘤患者34例的DSA影像、介入治疗及随诊结果进行回顾性分析并对血管内栓塞动脉瘤的效果及安全性进行评价。结果: 本组动脉瘤直径2.0~20.0mm,病情按Hunt-Hess法分级:Ⅰ级7例,Ⅱ级21例,Ⅲ级5例,Ⅳ级1例。全部患者均经DSA全脑血管造影确诊后采取血管内栓塞治愈,并经DSA随诊见完全栓塞的动脉瘤无复发,1例栓塞90%的动脉瘤复发,改行手术治疗;1例假性动脉瘤复发,经载瘤动脉内支架植入后治愈。无永久性并发症发生。结论: 采用电解可脱式铂金螺旋圈(GDC)或微支架辅助GDC血管内栓塞是治疗颅内动脉瘤的一种微创、安全、有效的方法,DSA全脑血管造影是诊断颅内动脉瘤和检验动脉瘤栓塞效果的可靠手段,近期随诊结果表明采取血管内栓塞动脉瘤效果可靠,大宗远期随诊结果尚待进一步观察。Abstract: Objective: To discuss the research of indication and results of endovascular embolization for intracranial aneurysms. Methods: The DSA images,interventional treatment and the results of follow-up of 34 cases that were undergone endovascular embolization and counterchecked by DSA were analyzed in retrospect.And the results and security of endovascular embolization for intracranial aneurysms were estimated. Results: In the group the diameter of intracranial aneurysms ranged from 2.0mm to 20.0mm,and the condition of patients according to Hunt-Hess grade were: grade Ⅰ in 7 cases,grade Ⅱ in 21,grade Ⅲ in 5 and grade Ⅳ in 1.All the cases were diagnosed by DSA and cured by endovascular embolization.In follow-up 1 case whose cavity of aneurysm was occluded with GDC by 90% and 1 case of pseudoaneurysm were recurred.The previous one was managed by surgical operation and the other one was cured by the planting of stent in the parent artery. Conclusion: Endovascular embolization with Guglielmi detachable coil(GDC) or GDC combining with stent is a minimal traumatic,secure and effective method of treatment for intracranial aneurysms.DSA is the credible means to diagnose intracranial aneurysms and to check up the result of embolization for intracranial aneurysms.The treatment results are well in the near period followup,but that will be much more investigated in the long period follow-up of a great number of patients.
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