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目的 探讨可脱性弹簧圈及可脱性球囊血管内栓塞治疗颅内动脉瘤的效果及技术要点。方法 对 194例颅内动脉瘤应用微导管技术 ,在数字减影血管造影监视下行血管内栓塞治疗 ,其中 85例 90个动脉瘤用机械式可脱性弹簧圈 (MDS)栓塞 ,6 9例 71个动脉瘤用电解式可脱性弹簧圈(GDC)栓塞。 40例巨大动脉瘤 37例用可脱性球囊闭塞载瘤动脉 ,2例用GDC ,1例用MDS闭塞载瘤动脉。结果 成功栓塞 194例 2 0 1个动脉瘤 ,191例痊愈 ,3例死亡。栓塞程度 :10 0 %栓塞 187个 (包括载瘤动脉闭塞者 ) ,95 %栓塞 8个 ,90 %栓塞 4个 ,80 %栓塞 1个。术中动脉瘤破裂 4例 ,并发脑梗死 4例 ,1例微弹簧末端逸出并顽固性脑血管痉挛。 2例复发者再给予GDC栓塞而治愈。结论 血管内栓塞治疗颅内动脉瘤是一种比较安全、可靠、有效的治疗手段 ,动脉瘤较大者 ,术后复发率高 ;术前反复蛛网膜下腔出血者 ,术中动脉瘤破裂的可能性较大。
Objective To investigate the effect and technical points of treatment of intracranial aneurysms with detachable coil and detachable balloon endovascular embolization. Methods One hundred and ninety-four patients with intracranial aneurysm were treated with endovascular embolization with digital subtraction angiography. 85 aneurysms of 90 patients were treated with mechanical detachable coil (MDS) embolization, 69 patients An aneurysm was embolized with an electrolytically detachable coil (GDC). Thirty-seven patients with giant aneurysms occluded the parent artery with a detachable balloon, two with GDC, and one with MDS occluding the parent artery. Results A total of 194 cases with 201 aneurysms were successfully embolized, 191 were cured and 3 died. Degree of embolism: 187 were embolized (including those with aortic artery occlusion) at 10%, 8 were 95% embolized, 4 were 90% embolized, and 1 was embolized at 80%. Intraoperative aneurysm rupture in 4 cases, complicated by cerebral infarction in 4 cases, 1 case of spring tip escape and intractable cerebral vasospasm. 2 cases of relapse were given GDC embolization and cure. Conclusions Endovascular embolization is a safe, reliable and effective treatment for intracranial aneurysms. The larger the aneurysm, the higher the recurrence rate after surgery. The patients with repeated subarachnoid hemorrhage and intraoperative aneurysm rupture More likely.