摘要
目的探讨老年颅内破裂型动脉瘤患者的临床特点，总结在急性期球囊辅助栓塞动脉瘤的经验。方法选择76例老年破裂型囊状动脉瘤患者，共发现动脉瘤81枚；75枚动脉瘤的瘤体／瘤颈（body／neck，B／N）≥1，其中B／N≥2的有29枚，使用球囊辅助技术1次栓塞即达到满意效果。1≤B／N〈2的有36枚，30枚动脉瘤使用球囊辅助技术1次栓塞即达到满意效果；另外6枚动脉瘤急诊I期行球囊辅助部分栓塞，动脉瘤残余部分Ⅱ期行支架辅助栓塞术。另外有4枚B／N〈1，急诊使用支架结合技术进行栓塞。2枚未能成功栓塞的动脉瘤皆为非出血责任病灶。栓塞术中球囊扩张次数平均为（2．1±1．3）次，单次扩张充盈时间平均为（33．4士14．1）s。结果球囊辅助栓塞术中发生动脉血栓患者2例（2．7％），4枚动脉瘤（5．3％）术中发生破裂。术中无支架相关性血栓形成。出院时Glasgow评分良好68例，较差8例，无死亡病例。随访无迟发血管内血栓及颅内梗死灶。结论在急性期老年破裂型动脉瘤的栓塞术使用封堵球囊安全有效，特别在预防动脉瘤破裂中发挥了良好的作用。
Objective To introduce our experience in embolizing cerebral ruptured-aneurysms of elderly patients in our hospital. Methods Totally 76 elderly patients were referred to our hospital due to ruptured-aneurysms. 81 aneurysms were confirmed by DSA, all of them were sac aneurysms, among which 75 cases （body/neck≥ 1） were treated with balloon-assisted coiling, 29 narrow-necked （body/neck≥2） aneurysms and 30 wide-necked （1≤ body/neck〈 2） aneurysms were treated with balloon-assisted coiling successfully, but 6 narrow-necked （body/neck≥2） were treated with balloon- assisted coiling in emergency, followed by a stent-assisted coiling in secondary embolization, 4 cases with body/neck〈1 were treated with stent-assisted coiling technique in emergency, 2 non-ruptured aneurysms could not be treated. The times of balloon dilation were （2.1± 1.3）, single expansion of filling was （33.4±14.1）s. Results The arterial thrombosis happened in two patients （2.7%）, two aneurysms ruptured （5.3%） during the procedure. No stent-related thrombosis happened. 86 were elevated as good, 8 as serious according to the Glasgow outcome scale, neither died after operation or delayed thrombosis or infarction lesion during following up. Conclusions Balloonassisted coiling is a safe and effective method in elderly patients during acute stage of rupturedaneurysms.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2012年第8期686-688,共3页
Chinese Journal of Geriatrics
关键词
颅内动脉瘤
栓塞
球囊
支架
Intraeranial aneurysm Embolism
Saccule
Stents
