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目的探讨电解脱弹簧圈(Guglialm i detachab le coil,GDC)颅内动脉瘤栓塞术中动脉瘤再破裂的发生率、原因、对策及结果。方法302例颅内动脉瘤破裂患者行GDC栓塞术,其中8例发生术中动脉瘤再破裂。结果2例由微导丝穿破动脉瘤壁引起,3例由微导管穿破动脉瘤壁引起,2例由置放首枚弹簧圈时顶破动脉瘤壁引起,l例术中自发破裂,所有病例均继续行GDC动脉瘤填塞。2例死于动脉瘤破裂后大出血,其他6例均康复没有留下后遗症。本组术中动脉瘤再破裂发生率为2.6%,死亡率为25%。结论GDC血管内栓塞术中引起动脉瘤再破裂是十分少见的,但大部分病例经过继续填塞GDC可达到完全填塞动脉瘤,且不留下后遗症。
Objective To investigate the incidence, causes, countermeasures and results of aneurysm rupture during the intracranial aneurysm embolization in patients with Guglial il detachab le coil (GDC). Methods 302 patients with ruptured intracranial aneurysms underwent GDC embolization, of which 8 cases of intraoperative aneurysm rupture again. Results 2 cases caused by micro-guide wire through the wall of the aneurysm, 3 cases caused by microcatheter wall rupture of the aneurysm, 2 cases caused by placing the first coil ruptured the aneurysm wall, l cases of spontaneous rupture, GDC aneurysm stuffing was continued in all cases. 2 died of aneurysm rupture after bleeding, the other 6 cases did not leave sequelae of rehabilitation. The incidence of aneurysm rupture in this group was 2.6%, the mortality rate was 25%. Conclusions Aneurysm rupture caused by GDC endovascular embolization is very rare, but in most cases GDC can achieve complete aneurysm closure without sequelae.