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目的:比较评价 MDS 和 GDC 栓塞颅内动脉瘤的疗效。材料和方法:28例颅内动脉瘤(宽颈动脉瘤6例,狭颈动脉瘤22例)患者接受了血管内治疗,其中 MDS 栓塞9例,GDC 栓塞19例。术后即时和6个月后作血管造影以评价其栓塞效果。结果:28例经血管治疗手术成功26例,失败2例。在用 MDS 栓塞成功的8例中,完全栓塞2例(25%),大部栓塞(栓塞范围>70%)3例(38%),部分栓塞(栓塞范围<70%)3例(38%)。在用 GDC 栓塞成功的18例中,完全栓塞12例(67%),大部栓塞4例(22%),部份栓塞2例(11%)。术后6个月随访血管造影7例,无1例显示动脉瘤再开放。术后血栓形成发生2例,1例2周后完全恢复,另1例留有永久后遗症。1例手术失败,因动脉瘤再次破裂1周后死亡。结论:在狭颈动脉瘤,经血管治疗技术可完全闭塞动脉瘤腔,GDC 的可操作性和治疗效果要优于 MDS。
Objective: To compare the efficacy of MDS and GDC embolization of intracranial aneurysms. MATERIALS AND METHODS: Twenty-eight patients with intracranial aneurysms (6 cases of wide-necked aneurysms and 22 cases of narrow-necked aneurysms) underwent endovascular therapy. Among them, 9 were MDS and 19 were GDC. Angiography was performed immediately and 6 months later to evaluate the embolic effect. Results: Twenty - eight cases were successfully treated by vascular surgery in 26 cases and failed in 2 cases. Among the 8 cases successfully embolized with MDS, 3 cases (38%) had partial embolization (embolization range <70%), 2 cases (25% ). Of the 18 patients successfully treated with GDC, 12 (67%) had complete embolization, 4 (22%) had major embolization and 2 (11%) had partial embolization. Six patients were followed up for angiography at 6 months. No aneurysm was reopened in 1 patient. Postoperative thrombosis occurred in 2 cases, 1 case completely recovered after 2 weeks, the other case left a permanent sequelae. One patient had failed surgery and died after another rupture of the aneurysm. Conclusion: In the narrow-necked aneurysms, transcatheter arterial occlusion of aneurysm can be completely occluded by transcatheter arterial angioplasty. The operability and therapeutic effect of GDC are superior to those of MDS.