Byrne J
Department of Neuroradiology, Radcliffe Infirmary, Oxford, UK.
Br J Radiol. 1996 Oct;69(826):891-9. doi: 10.1259/0007-1285-69-826-891.
During the last 10 years, the development of flexible microcatheters which can navigate cerebral vessels to lesions deep within the brain, has allowed the treatment of an increasing range of intracranial pathologies, including aneurysms. Techniques to embolize aneurysms, either by occlusion of their parent artery or endosaccular packing with its preservation, have evolved largely in order to treat inoperable aneurysms. Endosaccular packing with thrombogenic coils has recently allowed embolization of smaller aneurysms to be performed in patients acutely ill after subarachnoid haemorrhage. The procedural morbidity associated with these endovascular treatments are less dependent on aneurysm site than conventional neurosurgical clipping and initial results are comparable. These developments are challenging current thinking on the surgical management of patients with intracranial aneurysms. This review describes the evolution and practice of current endovascular treatments and their possible implications for the future of neuroradiology.
在过去十年中，能够在脑血管中导航至脑深部病变的柔性微导管的发展，使得越来越多的颅内病变，包括动脉瘤，得到了治疗。通过闭塞动脉瘤的供血动脉或在保留动脉瘤的情况下进行瘤内填塞来栓塞动脉瘤的技术，在很大程度上是为了治疗无法手术的动脉瘤而发展起来的。使用血栓形成线圈进行瘤内填塞最近使得在蛛网膜下腔出血后病情严重的患者中能够对较小的动脉瘤进行栓塞。与这些血管内治疗相关的手术并发症比传统神经外科夹闭术对动脉瘤部位的依赖性更小，且初步结果相当。这些进展正在挑战当前关于颅内动脉瘤患者手术管理的观念。本综述描述了当前血管内治疗的演变和实践及其对神经放射学未来可能产生的影响。
