【摘要】 目的探讨复杂性颅内动脉瘤血管内治疗方法的选择及其效果评价。方法对2 0 0 5年1月~2 0 0 7年1月收治的经DSA确诊的复杂性颅内动脉瘤1 2例进行了经皮穿刺血管内治疗,其中椎动脉瘤1例,基底动脉瘤4例,后交通动脉瘤1例,眼动脉瘤2例,颈动脉海绵窦段动脉瘤2例,前交通动脉瘤2例,分别采用了球囊,GDC,水解弹簧圈,Neuroform支架辅助水解弹簧圈或GDC栓塞技术。其中1例眼动脉瘤合并颈动脉海绵窦动静脉瘘,1例颈动脉海绵窦段动脉瘤破裂引起海绵窦动静脉瘘合并大脑中动脉动静脉瘘。结果8例1 0 0%弹簧圈致密填塞,2例9 5%以上填塞,1例获9 0%填塞,1例行球囊动脉瘤栓塞术。1例眼动脉瘤因发生颈内动脉斑块脱落于大脑中动脉术后出现脑梗塞灶引起肢体偏瘫,经治疗后好转;1例眼动脉瘤行球囊动脉瘤栓塞术3月后复发,因经济困难而行开颅手术治疗,其余病例血管内治疗术后临床症状消失或好转。1 2例随访3月-2 4个月,无再出血或症状加重。结论血管内治疗是复杂性颅内动脉瘤治疗的主要方法之一,只要选择合适的病例及适当的栓塞技术和栓塞材料,将会获得满意的临床效果。但血管内治疗仍然有与栓塞技术及材料相关的并发症,长期疗效有待于进一步随访。更多还原

【Abstract】 Objective To study the endovascular management with complex intracranial aneurysms in terms of methodology,technical tips,efficiency and application.Methods from Jan 2005 to Jan.2007,12 patients of complex intracranial aneurysms were embolized with ballon,GDC,hydrocoils,and GDC with neuroform stent,including 1 vertevral aneurysm,4 basilar aneurysms,1 posterior communicating aneurysm,2 opthalmic aneurysms,2 ICA C2 aneurysms,and 1 anterior communicating anaurysm.Resultstotal occlusion was achieved in 8 aneurysms,over 95% occlusion in 2 aneurysms,and 90% in 1.One aneurysm was embolized with ballon.Hemiplegia occurred to one patient with opthalmic aneurysm due to cerebral infarction.One patient chose craniotomy due to ophthalmic aneurysm recurrence.The symptoms of the rest of the patients have disappeared or reduced.Conclusionsendovascular management is one of the major methods for treating complex intracranial aneurysms.Proper embolism techniques and methods combined with suitable embolism material will bring satisfactory clinical results.However,complications related to embolism techniques and methods still occur with endovascular management and long-term follow-up is necessary.更多还原