摘要
目的 探讨颅内动脉瘤微导管血管腔内治疗 (ITM)的并发症及防治 ,提高ITM安全性和成功率。方法 颅内动脉瘤 2 3例 ,经机械解脱微螺圈栓塞 19例 ,游离微螺圈栓塞 1例。结果 误栓死亡 1例 ,继发性脑栓塞 1例 ,脑血管痉挛 2例 ,并发症发生率 17 4%。ITM成功率 82 6 %。结论 ITM器材的进步、术者对脑血管解剖和血流的熟悉及导管操作熟练 ,是减少并发症 ,提高治疗成功率的保证。正确选择与动脉瘤相适应的弹簧栓 ,对高血流动脉瘤采取阻控法栓塞等 ,可有效防止误栓。
Objective To discuss the prevention of complications of intravascular therapy by microcatheter for intracranial aneurysms. Methods 23 cases of intracranial aneurysms (AN),including 9 PcoAAN,5 AcoAAN,4 MCAAN,2 ACAAN,1 C 1AN,1 C 2AN and 1 with many aneurysms (PcoAAN+C 4AN).All cases were diagnosed by DSA.19 cases were embolized by BALT MDS-N spiral,and 1 case of great C 1AN was embolized by Chinese free spiral.Results One died of accident bolt,one happened cerebral embolism,two happened cerebrovascular convulsions and obtained secondary success after treatment.Complication rate was 17 4%.Another 3 cases were failed because of grave circuity of internal carotid artery and wide neck of aneurysms.ITM success rate was 82 6%.Conclusion Advancement of equipment,especially detachable microcoil,hydrospeed microguide and microcatheter,and skilled operating are the guarantee that reducing complication and improving success rate.Right choice fit microcoil,and high blood stream aneurysm embolized by block control are good for preventing accident bolt.Convulsion prevention is important.Avoiding bad stimulations,sufficiently expanding vessels and mild operating are necessary.Patients should be strictly heparinized.Stop ITM when complications happen,treat with coagulation,expand vessels,dissolve thrombosis and take bolt.If aneurysm broken,the first choice is embolization of the cavity and hemostate immediately.
出处
《云南医药》
CAS
2000年第2期87-89,共3页
Medicine and Pharmacy of Yunnan
