颅内大型、巨大型动脉瘤血管内治疗长期血管造影随访

发布时间：2018-08-07 17:26

【摘要】：目的探讨血管内治疗颅内大型或巨大型动脉瘤的疗效和长期血管造影随访结果。方法回顾性分析72例颅内大型或巨大型动脉瘤血管内治疗患者的临床资料,其中单纯弹簧圈栓塞30例,支架辅助弹簧圈栓塞14例,覆膜支架治疗15例,载瘤动脉闭塞术13例。结果单纯弹簧圈完全栓塞10例,支架辅助弹簧圈完全栓塞7例,覆膜支架11例,载瘤动脉闭塞13例,总术后即刻完全栓塞率达到56.9%;单纯弹簧圈近完全栓塞17例,支架辅助弹簧圈近完全栓塞6例,覆膜支架4例,总术后即刻近完全栓塞率37.5%;单纯弹簧圈不完全栓塞3例,支架辅助弹簧圈不完全栓塞1例,总术后即刻不完全栓塞率5.6%。随访6~72个月,平均随访24.2个月,所有患者无再出血。围手术期总的并发症率为9.7%,无死亡病例。不同血管内治疗方法对动脉瘤复发率的比较发现,单纯弹簧圈栓塞治疗比其他治疗方法治疗动脉瘤患者复发率高。总的复发率是23.6%。再次用血管内成功治疗14例复发动脉瘤。结论血管内介入治疗颅内大型或巨大型动脉瘤安全有效,远期复发率较高,应加强随访观察。根据动脉瘤部位及形态特点,合理采用相应的血管内介入治疗可有助于提高临床治疗效果,降低复发率。
[Abstract]:Objective to investigate the effect of intravascular treatment of intracranial large or giant aneurysms. Methods the clinical data of 72 cases of intracerebral large or giant aneurysms were retrospectively analyzed, including 30 cases of single coil embolization, 14 cases of stent assisted coil embolization, 15 cases of covered stent treatment, and carrying tumor movement. 13 cases of pulse occlusion. Results pure coils were completely embolized in 10 cases, stent assisted coil complete embolization in 7 cases, covered stent 11 cases, aneurysm artery occlusion in 13 cases, total embolism rate reached 56.9% after total operation, 17 cases were close complete embolism of spring coil, 6 cases of stent assisted coils near complete embolism, 4 cases with covered stent, almost complete immediately after total operation. The rate of embolization was 37.5%, 3 cases with incomplete coils embolism and 1 cases with incomplete embolization with stent assisted coils. The immediate postoperative incomplete embolism rate was 5.6%. for 6~72 months, the average follow-up was 24.2 months, and no rebleeding was found in all patients. The total complication rate in the perioperative period was 9.7%, no death cases. It is found that the recurrence rate of aneurysm patients is higher than that of other treatment methods. The total recurrence rate is 23.6%. again successfully treated 14 recurrent aneurysms with intravascular treatment. Conclusion intravascular interventional therapy for large or giant intracranial aneurysms is safe and effective, and the long-term recurrence rate is high. The follow-up observation should be strengthened. The location and morphology of the tumor and the appropriate endovascular interventional therapy can help to improve the clinical effect and reduce the recurrence rate.
【作者单位】：新疆医科大学第一附属医院神经外科;新疆医科大学第一附属医院介入放射科;
【基金】：新疆维吾尔自治区自然科学基金资助项目(2013211A096)资助
【分类号】：R743

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