CAJ | 학술논문

目的探讨颅内微小动脉瘤血管内治疗时妨碍微导管插管和稳定到位的不利因素及其对策.方法回顾2001年6月至2009年10月间46例51个颅内微小动脉瘤的血管内治疗资料,分析术中微导管插管和稳定到位的影响因素及其相应的可能对策.结果在血管内治疗时可能妨碍微导管插管和稳定到位的因素有:微导管走行的路径,载瘤动脉迂曲,路径、载瘤动脉直径与微导管直径相差较大,路径、载瘤动脉的走行方向与动脉瘤瘤顶的指向不在同一方向且差异较大,以及载瘤动脉内动脉瘤颈处放置了支架.结论根据路径、载瘤动脉的走行、动脉瘤的位置和瘤顶的指向,选择顺应性、稳定性与导引性、支撑性适宜并匹配的微导管与微导丝,并对其头端进行塑形,酌情选用球囊或(和)支架辅助,加之娴熟的插管技术,是颅内微小动脉瘤血管内治疗时微导管插管和稳定到位的有效方法 .
목적 탐토로내미소동맥류혈관내치료시방애미도관삽관화은정도위적불리인소급기대책.방법 회고2001년6월지2009년10월간46례51개로내미소동맥류적혈관내치료자료,분석술중미도관삽관화은정도위적영향인소급기상응적가능대책.결과 재혈관내치료시가능방애미도관삽관화은정도위적인소유:미도관주행적로경,재류동맥우곡,로경、재류동맥직경여미도관직경상차교대,로경、재류동맥적주행방향여동맥류류정적지향불재동일방향차차이교대,이급재류동맥내동맥류경처방치료지가.결론 근거로경、재류동맥적주행、동맥류적위치화류정적지향,선택순응성、은정성여도인성、지탱성괄의병필배적미도관여미도사,병대기두단진행소형,작정선용구낭혹(화)지가보조,가지한숙적삽관기술,시로내미소동맥류혈관내치료시미도관삽관화은정도위적유효방법 .
Objectives To investigate adverse factors that may hinder successful placement and stabilization of the microcatheter during endovascular therapy of micro-intracranial aneurysms (≤ 3 mm in maximum diameter), and to explore the relevant managements. Methods Forty-six patients with fifty-one micro-intracranial aneurysms treated by endovascular therapy from June 2001 to October 2009 were retrospectively analyzed for their intervention data. Results Adverse factors of optimal micro-catheterization mainly included, tortuosity of the proximal vessels (PVs)and the parent artery (PA), relative large gap in diameter among the PVs, the PA and the microcatheter, relative large divergence in direction among the PVs, the PA and the aneurysm dome, and stent deployed in the PA. Conclusions Carefully considering the direction of the PVs and the PA, the aneurysm's location and dome orientation,choosing the microcatheter and microwire after balancing among their physical properties, as well as utilizing balloon and/or stent assistance, can facilitate micro-catheterization during endovascular treatment of micro-intracranial aneurysms.