新型3维弹簧圈篮筐技术栓塞宽颈动脉瘤

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

【机构】 广东省中医院脑血管病中心；

【摘要】 目的总结采用3D 弹簧圈篮框技术栓塞治疗76例颅内宽颈动脉瘤的经验,分析各种新型3D 弹簧圈篮框技术治疗宽颈动脉瘤的优缺点、技术操作要点和存在问题。方法 76例宽颈动脉瘤中65例为破裂动脉瘤,11例为未破裂动脉瘤,对58例动脉瘤采用电解可脱3D 弹簧圈篮框技术进行栓塞治疗,18例动脉瘤采用水解成篮形弹簧圈栓塞。将微导管放入动脉瘤囊后,首先将一合适的3维弹簧圈推送入动脉瘤内,形成三维篮筐,再于篮筐内进一步填塞弹簧圈栓塞动脉瘤。结果完全栓塞动脉瘤55例,次全栓塞18例,部分栓塞3个,术中动脉瘤破裂1个,随访49例,随访时间6月—3年无动脉瘤再出血,复发3例,1例采用支架辅助技术再次栓塞。结论采用3D 弹簧圈篮框技术栓塞动脉瘤体/颈比大于1的宽颈动脉瘤,不需要临时阻断载瘤动脉,有较高的安全性,效果可靠,多数可达到致密填塞。对部分宽颈动脉瘤需同时借助球囊或支架技术才能完成对宽颈动脉瘤的致密填塞。更多还原

【Abstract】 Purpose:To find out the fos and pro,the technique points of present commercial available 39 coils in treating wide-necked aneurysms by analyzing our 76 wide-necked aneurysm cases experiences.Method: Among the 76 wide-necked aneurysms,65 were ruptured aneurysm,11 were unruptured aneurysm.An appropriate 3D coil was used as the first frame coil to form a basket in the treatment of all aneurysms.Then aneurysms were further filled with different coils.Electric detachable 3D coils were used in 58 cases,while injection detachable 3Dcoits were used in 18 cases.Result:Complete aneurysm obliteration were achieved in 55 cases, near complete obliteration were seen in 18 cases,partial obliteration appeared in only 3 cases. Intraoperative rupture occurred in 1 case.49 cases were angiographically followed up in a 6-month to 3-year duration with no recurrent hemorrhage.3 aneurysms recurred and 1 was repacked with stent remodeling techniques. Conclusion:3D frame coil is useful in embolizing wide necked aneurysm with high safety and reliable result. Dense packing could be realized in most cases.更多还原