Gupta V, Gandhi C D, Prestigiacomo C J
Department of Neurological Surgery, New Jersey Medical School, University of Medicine and Dentistryof New Jersey, Newark, NJ, USA.
J Neurosurg Sci. 2012 Sep;56(3):163-74.
Rapid technological advances in the endovascular field has revolutionized the treatment of intracranial aneurysms. Since the Food and Drug Administration approval of Guglielmi detachable coils in 1995, a variety of newer coils with different design and physical properties such as complex coils, stretch resistant and bioactive coils, have become available promising to increase packing density and decrease aneurysmal recurrence and recanalization rates. Treatment of wide neck intracranial aneurysms has improved with availability of compliant balloons and newer intracranial assist devices. Emerging technology such as flow diverters hold promise in treatment of large and difficult to treat intracranial aneurysms. Liquid embolic agent (Onyx HD 500) offer a novel, safe and effective adjunctive treatment option when used in combination with coils with stent and/or balloon assist technique. Endovascular treatment options have vastly expanded the armamentarium of neurosurgeons allowing safe and durable treatment of aneurysms previously amenable to clipping only.
血管内介入领域的快速技术进步彻底改变了颅内动脉瘤的治疗方式。自1995年美国食品药品监督管理局批准使用 Guglielmi 可脱性弹簧圈以来，各种设计和物理特性不同的新型弹簧圈，如复杂弹簧圈、抗拉伸和生物活性弹簧圈已投入使用，有望提高栓塞密度并降低动脉瘤复发和再通率。随着顺应性球囊和新型颅内辅助装置的出现，宽颈颅内动脉瘤的治疗也得到了改善。新兴技术如血流导向装置有望用于治疗大型和难以治疗的颅内动脉瘤。液体栓塞剂（Onyx HD 500）与弹簧圈联合使用并结合支架和/或球囊辅助技术时，提供了一种新颖、安全且有效的辅助治疗选择。血管内治疗选择极大地扩展了神经外科医生的治疗手段，使以前仅适合夹闭的动脉瘤能够得到安全、持久的治疗。
