摘要
目的探讨颅内动脉瘤栓塞术中破裂的危险因素,总结其防治措施,以期提高手术安全性。方法回顾血管内栓塞治疗的198例颅内动脉瘤患者(212个动脉瘤)的栓塞过程,对发生术中破裂的病例,分析其动脉瘤形态特征、术中过程和预后。结果 4个动脉瘤术中发生破裂,有3次因为弹簧圈、1次因为微导管突出。发生破裂后,立即中和肝素,其中3例分别采用球囊辅助栓塞、双微导管等技术继续栓塞止血,1例行脑室外引流术。1例术后发生一过性偏瘫,1 w后恢复。4例均无永久性并发症残留。结论栓塞术中破裂少见,但难以避免。充分准备并选择恰当的栓塞方案,可以降低其发生风险并减轻其带来的危害。
Objective To discuss the risk factors for intraoperative rupture（IOR） of intracranial aneurysms in order to improve the safety of treatment.Methods A review of 198 patients with 212 intracranial aneurysms treated by coil embolization was conducted.All intraoperative rupture cases during coil embolization were identified and the morphologic characteristics of the aneurysms,the procedure and outcome were analyzed.Results There were 4 cases with intraoperative rupture of aneurysm during coil embolization,including protrusion of coil in 3 cases and microcatheter in 1 case.In case of IOR,heparin reversal with protamine sulfate were performed.Endovascular coiling was continued with balloon remodeling and double microcatheter technique in 3 cases,and external ventricular drainage was carried out in 1 case.One patient suffered transient hemiparesis as a result of the aneurysmal rupture and got recovety 1 w later.No long-term complications was observed in all 4 patients.Conclusion IOR is rare but unavoidable.Meticulous preparation and proper measurement can reduce its occurrence and improve the outcome.
出处
《中华神经外科疾病研究杂志》
CAS
2011年第4期356-359,共4页
Chinese Journal of Neurosurgical Disease Research
基金
武汉市科技局科技攻关计划重点基金资助项目(200960323130)
关键词
颅内动脉瘤
栓塞
并发症
术中破裂
Intracranial aneurysm
Embolization
Complication
Intraoperative rupture
