摘要
目的 评估脑动脉瘤电解脱铂金圈 (EDPC)栓塞治疗的临床疗效 ,探讨手术时机及术中操作注意事项。资料与方法 1999年 2月～ 2 0 0 3年 2月用EDPC栓塞治疗脑动脉瘤 32例。其中 30例为蛛网膜下腔出血 (SAH)患者 ,术前Hunt&Hess分级 :19例为Ⅰ级 ,6例为Ⅱ级 ,5例为Ⅳ～Ⅴ级。 32例 33个动脉瘤 ,均采用EDPC治疗。EDPC为美国波士顿科学国际有限公司下属Target公司生产的GDC和德国Dendron公司生产的EDC两种。为了安全、准确地栓塞动脉瘤 ,在放置铂金圈过程中及解脱前均行透视监视和数字减影血管造影 ,以监控栓塞的动脉瘤全程。结果 32例脑动脉瘤患者共 33个动脉瘤中 ,31个动脉瘤栓塞成功 ,2个因载瘤动脉严重痉挛失败 ,占 6 %。按动脉瘤的填塞程度分为 :完全填塞 2 4例 (72 .7% ) ,不完全填塞 6例 (18.1% ) ;2例梭形动脉瘤行载瘤动脉栓塞。非血栓性并发症发生率 9%。无血栓形成及血栓性栓塞并发症 ,亦无神经功能障碍、瘫痪和死亡等永久性并发症。结论 EDPC栓塞治疗动脉瘤是目前比较理想的治疗方法 ,其创伤小 ,操作简便 ,术后恢复快 。
Objective To assess the therapeutic effect of electro-detachable platinum coils (EDPC) in the embolization of cerebral aneurysms, to discuss the opportune moment for the therapy and the points for attention during the procedure.Materials and Methods During the period of Feb. 1999～Feb. 2003, 32 patients of cerebral aneurysms were treated with EDPC. Of 32 patients, 30 were subjected to subarachnoid hemorrhage (SAH), of which pre-operative Hunt & Hess grading was grade Ⅰ in 19, grade Ⅱ in 6 and grade Ⅳ～Ⅴ in 5. Thirty-three aneurysms were found in this series. Two kinds of EDPC were used in this study: (1) Guglielmi detachable coil from Boston Scientific Corporation of United States, and (2) Sapphire detachable coil from Micro Therapeutics Incorporation of Germany. In order to accurately and safely embolize the aneurysmal lumen, the whole EDPC procedure was closely monitored, both fluoroscopically and angiographically.Results Of the total 33 aneurysms, 31 were successfully embolized and 2 were failed to be blocked due to arterial spasm. The packing degree of the aneurysmal lumen was complete in 24 cases (72.7%) and incomplete in 6 cases (18.1%). Two fusiform aneurysms were treated with parent artery occlusion technique. The incidence of non-thrombotic complication was 9%. No thrombosis, dysneuria or other serious complications occurred.Conclusion As an endovascular treatment of intracranial aneurysm, EDPC is effective, minimally-invasive and simple with fast recovery after the procedure.
出处
《临床放射学杂志》
CSCD
北大核心
2004年第7期613-617,共5页
Journal of Clinical Radiology
基金
江苏省卫生厅重点资助项目 (编号H2 0 0 12 )
关键词
脑动脉瘤
电解脱铂金圈
栓塞治疗
疗效观察
Aneurysm, intracranial Electro-detachable platinum coil Embolization, therapeutic
