[用 Guglielmi 可脱性弹簧圈栓塞术治疗急性破裂动脉瘤]
[Treatment of acute ruptured aneurysm with Guglielmi detachable coil embolization].
作者信息
Liu Ming, Hua Xu-ming, Wan Liang, Jiang Feng, Zhong Jun, Ma Jie
机构信息
Department of Neurosurgery, Xinhua Hospital, Shanghai Second Medical University, Shanghai 200092, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2003 May 10;83(9):756-8.
OBJECTIVE
To investigate the curative effect of Guglielmi detachable coil (GDC) on acute ruptured intracranial aneurysms.
METHODS
The clinical data of 34 patients with acute rupture of intracranial aneurysms treated with early GDC embolization within 6 days after the rupture, 6 being of grade I, 23 of grade II, 4 of grade III and 1 of grade IV according to Hunt-Hess grading, were analyzed retrospectively. Fourteen patients were treated within 3 days, and 20 patients were treated in the 4th to 6th days after the rupture. Two cases of wide-neck aneurysm were embolized with Medtronic AVE stent supported GDC. Angiography was used to observe the effects.
RESULTS
Angiography showed complete occlusion in 28 cases and 90% occlusion in 4 cases. One aneurysm was ruptured during the procedure. The caudal tip of GDC protruded to the parent vessel in 2 cases. Two cases failed to be embolized due to severe cerebrovascular spasm. There were no mortality and complications. No re-rupture occurred in the follow-up.
CONCLUSION
Less invasive and with less risk and complication, early GDC embolization is one of the ideal therapeutic methods to manage acute ruptured aneurysms.
目的
探讨 Guglielmi 可解脱弹簧圈（GDC）治疗急性破裂颅内动脉瘤的疗效。
方法
回顾性分析 34 例急性破裂颅内动脉瘤患者的临床资料，这些患者在破裂后 6 天内接受早期 GDC 栓塞治疗，根据 Hunt-Hess 分级，Ⅰ级 6 例，Ⅱ级 23 例，Ⅲ级 4 例，Ⅳ级 1 例。14 例患者在 3 天内接受治疗，20 例患者在破裂后第 4 至 6 天接受治疗。2 例宽颈动脉瘤采用美敦力 AVE 支架辅助 GDC 栓塞。采用血管造影观察疗效。
结果
血管造影显示 28 例完全闭塞，4 例闭塞 90%。1 例动脉瘤在操作过程中破裂。2 例 GDC 尾端突入载瘤血管。2 例因严重脑血管痉挛未能栓塞。无死亡及并发症发生。随访期间无再破裂发生。
结论
早期 GDC 栓塞术创伤小、风险及并发症少，是治疗急性破裂动脉瘤的理想治疗方法之一。
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