Kawamoto H, Inagawa T, Ikawa F, Takechi A, Ohbayashi N, Yahara K, Sakoda E, Sakamoto S
Department of Neurosurgery, Shimane Prefectural Central Hospital, Himebara-cho, Izumo, Shimane 693-8555, Japan.
No Shinkei Geka. 2000 Dec;28(12):1105-10.
We report two cases with embolization (coil embolization) using Guglielumi detachable coils of residual aneurysms following incomplete neck clipping. The first case, a 75-year-old woman suffered from a subarachnoid hemorrhage due to the rupture of a left internal carotid posterior communicating aneurysm in June, 1997. Neck clipping of the aneurysm was performed at day 1. Follow-up angiogram at day 7 showed a residual aneurysm involving the dome of the initial aneurysm. We performed coil embolization of the residual aneurysm following the angiogram. Almost complete obliteration of the aneurysm lasted during the follow-up period of two and a half years. The second case, a 71-year-old woman suffered from a subarachnoid hemorrhage due to the rupture of a right internal carotid posterior communicating aneurysm in May, 1999. Neck clipping of the aneurysm was performed at day 1. Follow-up angiogram at day 7 showed a residual aneurysm involving only a part of the initial aneurysm near the neck. Because no spontaneous thrombosis of the residual aneurysm was obtained after 2 months, we performed coil embolization of the residual aneurysm. Almost complete obliteration of the aneurysm lasted during the follow-up period of 7 months. These patients were discharged with good performance status. We consider the morphologic feature of the residural aneurysm to be most important for determining when to perform coil embolization of such residual aneurysms.
我们报告了两例在颈部夹闭不完全后使用 Guglielumi 可脱性弹簧圈对残留动脉瘤进行栓塞(弹簧圈栓塞)的病例。第一例,一名 75 岁女性于 1997 年 6 月因左颈内动脉后交通动脉瘤破裂导致蛛网膜下腔出血。在第 1 天进行了动脉瘤颈部夹闭术。第 7 天的随访血管造影显示残留动脉瘤累及最初动脉瘤的瘤顶。在血管造影后我们对残留动脉瘤进行了弹簧圈栓塞。在两年半的随访期内,动脉瘤几乎完全闭塞。第二例,一名 71 岁女性于 1999 年 5 月因右颈内动脉后交通动脉瘤破裂导致蛛网膜下腔出血。在第 1 天进行了动脉瘤颈部夹闭术。第 7 天的随访血管造影显示残留动脉瘤仅累及颈部附近最初动脉瘤的一部分。由于 2 个月后残留动脉瘤未出现自发血栓形成,我们对残留动脉瘤进行了弹簧圈栓塞。在 7 个月的随访期内,动脉瘤几乎完全闭塞。这些患者出院时功能状态良好。我们认为残留动脉瘤的形态特征对于确定何时对这类残留动脉瘤进行弹簧圈栓塞最为重要。