摘要
目的 评价颅内动脉瘤电解可脱性弹簧圈 (GDC)栓塞治疗的中、远期疗效。方法 采用GDC栓塞 131例共 134枚颅内动脉瘤 ,其中前交通动脉瘤 39枚 ,后交通动脉瘤 4 5枚 ,颈内动脉虹吸段动脉瘤 19枚 ,大脑中动脉瘤 14枚 ,大脑前动脉瘤 3枚 ,后循环动脉瘤 9枚 ,其他部位 5枚。宽颈动脉瘤 (瘤颈宽度 >4mm或瘤体颈比率 <2 ) 39枚 ,狭颈动脉瘤 79枚 ,瘤颈显示不清者 16枚。栓塞术后 15个月内随访DSA ,以与栓塞后即时DSA比较其变化。结果 在 39枚宽颈动脉瘤和 79枚狭颈动脉瘤中 ,完全、近完全闭塞者分别为 30枚 (76 92 % )和 75枚 (94 94 % ) ,两者差异有非常显著性意义(χ2 =8 6 4 3,P <0 0 1)。栓塞后即时完全、近完全闭塞的 118枚动脉瘤中 ,术后不同时期随访DSA显示均无变化 ;栓塞后即时部分疏松填塞的 16枚动脉瘤中 ,随访DSA显示动脉瘤缩小者 3枚 ,无变化者4枚 ,再开放扩大者 9枚。结论 GDC致密、完全栓塞颅内动脉瘤的近、中期疗效肯定 ,但定期随访行DSA检查是必要的 ,尤其是部分疏松填塞者 ,对于复发的病例 。
Objective To evaluate the middle long term efficacy of intracranial aneurysms with Guglielmi detachable Coil (GDC) embolization Methods 131 cases with 134 aneurysms were embolised with GDC Of them, 39 aneurysms were in the anterior communication artery, 45 in the posterior communication artery, 19 in the siphon segment of internal carotid artery, 14 in the mediate cerebral artery, 3 in the anterior cerebral artery, 9 in the posterior circle and 5 in other A wide neck ( neck>4 mm,or aneurysm body/neck<2 ) showed in 39 aneurysms, narrow neck in 79 and unclear in 16 Follow up DSA was performed in the period of 15 months after procedure in all 134 aneurysms, and a comparison to post embolization DSA was maken Results In 134 aneurysms with GDC embolization, a total or nearly total occlusion was aquired in 30 of 39 wide neck aneurysms (76 92%) and in 75 of 79 narrow neck aneurysms (94 94%), χ 2=8 643, P <0 01 Follow up DSA showed no change in 118 aneurysms which were a total or nearly total occlusion on post embolization DSA In 16 aneurysms with subtotal or partial occlusion, re open of aneurysm showed in 9 cases, reduced in 3, no change in 4 on follow up DSA Conclusion Although the recent midium term efficacy of intracranial aneurysms with GDC embolization is in the affirmative, a period follow up DSA is essential, especially in aneurysms with subtotal or partial occlusion Again, re embolization with GDC is recommended in a re open aneurysm
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2002年第9期797-801,共5页
Chinese Journal of Radiology
基金
上海市优秀学科带头人资助项目(0 0XD14 0 2 0)
上海市卫生系统"百人计划"资助项目(97BR0 3 8)
上海市重点医学发展基金项目 (98ZD0 0 3)资助
