应用新型MTI球囊辅助弹簧圈技术栓塞治疗颅内宽颈动脉瘤

【作者】 李贵福； 黄胜平； 李铁林； 张迎光； 白小欣； 朱吉祥； 罗望池； 林浩； 朱文燕； 黄燕； 蔡业峰；

【机构】 广东省广东省中医院脑血管病中心；

【摘要】 目的探讨采用新型 MTI 球囊重塑技术栓塞治疗颅内宽颈动脉瘤可行性及有效性．评价其栓塞和临床结果。方法本组共22例26个宽颈动脉瘤采用 MTI 新型球囊 Hyperglide 或 Hyperform 置于宽颈动脉瘤的载瘤动脉处同时将微导管置于动脉瘤内,充盈球囊封闭瘤颈口后将合适的弹簧圈推送进入动脉瘤内,每次充盈球囊的时间控制在5分钟内, 重复进行充盈球囊和填塞的过程,球囊将弹簧圈在瘤颈处重新塑形以达到动脉瘤致密填塞。结果 26个宽颈动脉瘤采用球囊重塑技术栓塞,23个成功填塞动脉瘤,2例前交通动脉瘤应用球囊辅助技术失败。1个因血管迂曲球囊不能到达大脑前动脉改用3D 弹簧圈篮筐技术栓塞,另一例前交通动脉瘤因选择 Hyperglide 球囊,球囊充盈时无法进入前交通动脉分支血管而不能封闭全部瘤颈导致部分弹簧圈进入载瘤动脉。1例因同时采用 Hydrocoil 水凝胶弹簧圈时,因弹簧圈过硬刺破动脉瘤引起动脉瘤术中破裂出血,病人死亡。结论为达到宽颈动脉瘤致密有效的栓塞,新型球囊重塑技术是一种很好的方法。更多还原

【Abstract】 Object:to evaluate the feasibility and efficacy of the balloon remodeling technique in the treatment of wide-necked aneurysms with new compliant balloons designed by MTI. Methods:in this series,22 cases with 26 wide-necked aneurysms were treated by balloon-assisted coiling technique with new compliant balloons (Hyoerglide or Hyperform,MTI,USA).In the procedure,the balloon was placed in the parent artery and inflated to occlude the neck of the aneurysm,while the tip of microcatheter was introduced into the aneurysm,and proper coils were then deposited.The inflation time of balloon was controlled within 5 minutes.The balloon was then deflated to verify appropriate coil placement and stability, and finally,the coils were detached.This process was repeated until the aneurysm was complitly embolized. Results:Of the 26 wide-necked aneurysms,23 were embolized successfully.Of the 2 ACoA wide-necked aneurysm in which the remodeling technique failed,1 recieved 3D coil basketing technique for the balloon can not reach the target artery due to the tortuosity of vessel,in another aneurysm,Hyperglide balloon inflation can not completely occlude the neck of the aneurysm (the balloon failed to pass into the A2 segment) to avoid coil dislodging into the patent artery.One case died because of the rupture of the aneurysm caused by over-rigid Hydrocoil during the procedure. Conclusion:this new compliant balloon is of great help for compact embolization of wide-necked aneurysms.更多还原