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目的:探讨可脱性弹簧圈血管内栓塞治疗颅内动脉瘤的效果及技术要点.方法:对126例颅内动脉瘤应用微导管技术,在数字减影血管造影(DSA)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(Machenical detachable spiral,MDS),栓塞,41例42个动脉瘤用电解式可脱性弹簧圈(Guglielmi detachabe coil,GDC)栓塞.结果:成功栓塞126例132个动脉瘤,123例痊愈,3例死亡.100%栓塞124个,95%栓塞6个,90%栓塞2个.并发动脉瘤破裂4例,并发脑梗死2例,其中1例痊愈,1例死亡;1例微弹簧末端逸出并顽固性脑血管痉挛.2例复发者再予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,但动脉硬化明显导管到位困难者及术前呼吸、循环功能衰竭者不宜行血管内治疗.术前尼莫通化,术中导管内推注罂粟碱可有效防止脑血管痉挛.动脉瘤较大者,术
Objective: To investigate the efficacy and technical points of endovascular embolization with coilable coils in the treatment of intracranial aneurysms. Methods: Intravascular embolization with digital subtraction angiography (DSA) monitoring in 126 patients with intracranial aneurysms using microcatheter technique In the treatment, 85 cases of 90 aneurysms were embolized with a mechanical detachable spiral (MDS) and embolization, and 41 cases of 42 aneurysms were embolized with a Guglielmi detachabe coil (GDC). RESULTS: 126 cases of 132 aneurysms were successfully embolized, 123 cases were cured, 3 cases died, 100% embolized 124 cases, 95% embolization 6, 90% embolization, combined aneurysm rupture in 4 cases, and cerebral infarction in 2 cases. One case recovered and one died; one case of micro spring escape and refractory cerebral vasospasm. Two cases of recurrence were cured by GDC embolization. Conclusion: Intravascular embolization is safer for intracranial aneurysms. Reliable and effective treatment methods, but those with difficulty in catheterization of arteriosclerosis and preoperative respiratory and circulatory failure are not suitable for endovascular treatment. Preoperative Nemotonization, intraoperative catheter push papaverine can effectively prevent cerebral vasospasm Larger aneurysm, surgery