摘要
目的:探讨大规格弹簧圈栓塞术在颅内动脉瘤治疗中的安全性、可行性、经济性和有效性。方法:回顾性分析2016年1—12月我院使用大规格弹簧圈(第一枚弹簧圈规格明显大于动脉瘤直径的弹簧圈)治疗的颅内动脉瘤患者40例,40枚动脉瘤,术后即刻采用脑血管造影评价所有患者的临床疗效,术后随访6个月后,再次进行脑血管造影以评价疗效。结果:40例颅内动脉瘤中破裂动脉瘤患者24例,未破裂动脉瘤患者16例。采用大规格弹簧圈治疗的动脉瘤共40枚,其中单纯弹簧圈栓塞21枚,支架辅助栓塞19枚,栓塞成功率为100%。动脉瘤长径平均值为(6.27±2.76)mm,动脉瘤直径平均值为(5.28±2.27)mm。每个动脉瘤平均使用弹簧圈(3.26±1.48)枚,弹簧圈平均长度为(34.95±27.22)cm,动脉瘤的平均固体填充率为(18.32±6.39)%。40枚动脉瘤术后即刻血管造影显示Raymond分级:Ⅰ级39枚,Ⅱ级1枚,术中未发生动脉瘤破裂出血以及血栓事件。术后6个月所有患者均行全脑血管造影复查,Raymond分级Ⅰ级39枚,Ⅱ级1枚,随访期间无死亡及再出血事件发生。结论:大规格弹簧圈栓塞术在颅内动脉瘤栓塞治疗中是安全有效的,其长期疗效有待进一步大样本量去验证。
Objective： To explore the safety, feasibility, economy and effectiveness of large-size coils embolization. Methods： 40 consecutive patients with intracranial aneurysms treated with large-size coils （ the first coil was obviously larger than the diameter of the aneurysm） from January to December 2016 in our center were analyzed retrospectively. Endovascular coiling treatment detials were analyzed according to the cerebral angiography immediately after treatment. Results ： A total of 40 aneurysms in 40 patients received endovascular treatment with sith large -size coils, 24 ruptured and 16 unruptured. The mean largest diameter of the aneurysms was （ 6.27±2.76） mm, the mean diameter of the aneurysms was （ 5.28±2.27） mm , of which 21 cases were embolized , 19 cases embolized with the assistence of stent. An average of （ 3.26±1.48） coils with a mean length of （ 34.95±27.22） cm per aneurysm was used, resulting in a mean packing density of （ 18.32 ±6 .39） % . The angiography immediately after treatment showed that among the 40 intracranial aneurysms 39 belonged to Raymond grade I , 1 belonged to Raymond grade I . No procedural aneurysm rupture and thromboembolic events observed during the operation. Follow-up angiography 6 months after the treatment revealed that 39 aneurysms were Raymond grade I , 1 aneurysms was Raymond grade n . During the follow -up period, no death and re -bleeding events occurred. Conclusions： For the treatment of intracranial aneurysms, large-size coils embolization is safe andeffective although its long-term results need to be further studied.
出处
《中华介入放射学电子杂志》
2017年第4期244-248,共5页
Chinese Journal of Interventional Radiology：electronic edition
基金
国家自然科学基金(81601583)
国家十三五重点研发计划(2016YFC1300702)
