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[GDC 18治疗破裂和未破裂动脉瘤:115例动脉瘤的血管造影结果及早期和中期随访]

[GDC 18 treatment of ruptured and non-ruptured aneurysms: angiographic results and early and midterm follow-up of 115 aneurysms].

作者信息

Gallas S, Gabrillargues J, Pasco A, Cognard C, Drouineau J, Pierot L, Herbreteau D

机构信息

Service de Radiologie, Centre Hospitalier Universitaire de Reims, Hôpital Maison-Blanche, Reims, France.

出版信息

J Neuroradiol. 2007 May;34(2):89-94. doi: 10.1016/j.neurad.2007.01.012.

Abstract

OBJECTIVES

To demonstrate the technical feasibility, safety and results of intracranial aneurysm treatment by coils of 0.018-inch diameter wire (GDC 18) for ruptured and non-ruptured intracranial aneurysms.

MATERIALS AND METHODS

From a commune database from five neuroradiological centers, we analysed endovascular technique with Gugliemi Detachable Coils (GDC) 18, complications of technique, acute angiographic occlusion results and long-term angiographic follow-up. Sixty-six percent of aneurysms were ruptured. The mean size of treated aneurysms was 13.7 mm.

RESULTS

Overall feasibility of coil 18 treatments was 95%. Acute angiographic results in 110 aneurysms demonstrated total occlusion in 63 aneurysms (57.2%), subtotal occlusion in 37 cases (33.6%), and incomplete occlusion in 10 cases (9%). A second treatment was performed in 15 cases; follow-up demonstrated 60 (61%) total occlusions, 32 (33%) subtotal occlusion and 5 (5%) incomplete. Five patients were lost to follow-up, and 8 patients had died. Stability of occlusion with these coils was 61%.

CONCLUSION

Coiling of intracranial aneurysms, ruptured or non-ruptured, using coils with a wire diameter of 0.018-inch is safe, with no more complications than standard coils. Remodelling technique is possible. This type of coils must be considered for treatment of large aneurysms.

摘要

目的

证明采用直径0.018英寸的弹簧圈(GDC 18)治疗破裂和未破裂颅内动脉瘤的技术可行性、安全性及效果。

材料与方法

从五个神经放射学中心的联合数据库中,我们分析了使用Gugliemi可脱卸弹簧圈(GDC)18的血管内技术、技术并发症、急性血管造影闭塞结果及长期血管造影随访情况。66%的动脉瘤为破裂型。治疗的动脉瘤平均大小为13.7毫米。

结果

弹簧圈18治疗的总体可行性为95%。110个动脉瘤的急性血管造影结果显示,63个动脉瘤(57.2%)完全闭塞,37例(33.6%)次全闭塞,10例(9%)不完全闭塞。15例进行了二次治疗;随访显示60个(61%)完全闭塞,32个(33%)次全闭塞,5个(5%)不完全闭塞。5例患者失访,8例患者死亡。这些弹簧圈闭塞的稳定性为61%。

结论

使用直径0.018英寸的弹簧圈对破裂或未破裂的颅内动脉瘤进行栓塞治疗是安全的,并发症并不比标准弹簧圈多。重塑技术是可行的。对于大型动脉瘤的治疗必须考虑使用此类弹簧圈。

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