CAJ | 학술논문

目的探讨3D弹簧圈瘤体重建、瘤颈塑型介入治疗前交通动脉瘤的方法及疗效.方法回顾性分析2009年9月—2012年9月收治的31例(31个)前交通动脉瘤患者的临床资料.所有患者均经双源CT血管造影(DSCTA)和全脑DSA检查确诊,其中破裂动脉瘤21例,未破裂动脉瘤10例.Hunt-Hess分级Ⅰ级17例、Ⅱ级12例、Ⅲ级2例.患者均采用3D弹簧圈瘤体重建、瘤颈重塑形技术血管内介入栓塞治疗.结果所有患者均成功放置3D弹簧圈,术毕即刻进行DSA及CT检查.DSA检查显示弹簧圈均位于动脉瘤内,载瘤动脉通畅,其中完全栓塞26例,占83.87％ (26/31);大部分栓塞5例,占16.13％(5/31).CT检查显示无脑梗死及脑出血现象.31例患者出院时采用格拉斯哥预后评分评价疗效:恢复良好26例,占83.87％(26/31);轻度残疾4例,占12.9％ (4/31);重度残疾l例,占3.22％(1/31).31例患者术后均获随访6～12(8.95±4.08)个月.术后3、6、12个月行DSA或CTA复查提示,前交通动脉轻度狭窄5例,前交通动脉通畅26例,无动脉瘤复发.结论 3D弹簧圈瘤体重建、瘤颈重塑技术栓塞治疗前交通动脉瘤,并发症少、疗效好,术后不需要长期服用抗凝药物,是一种安全、有效的治疗方法.
목적 탐토3D탄황권류체중건、류경소형개입치료전교통동맥류적방법급료효.방법 회고성분석2009년9월—2012년9월수치적31례(31개)전교통동맥류환자적림상자료.소유환자균경쌍원CT혈관조영(DSCTA)화전뇌DSA검사학진,기중파렬동맥류21례,미파렬동맥류10례.Hunt-Hess분급Ⅰ급17례、Ⅱ급12례、Ⅲ급2례.환자균채용3D탄황권류체중건、류경중소형기술혈관내개입전새치료.결과 소유환자균성공방치3D탄황권,술필즉각진행DSA급CT검사.DSA검사현시탄황권균위우동맥류내,재류동맥통창,기중완전전새26례,점83.87％ (26/31);대부분전새5례,점16.13％(5/31).CT검사현시무뇌경사급뇌출혈현상.31례환자출원시채용격랍사가예후평분평개료효:회복량호26례,점83.87％(26/31);경도잔질4례,점12.9％ (4/31);중도잔질l례,점3.22％(1/31).31례환자술후균획수방6～12(8.95±4.08)개월.술후3、6、12개월행DSA혹CTA복사제시,전교통동맥경도협착5례,전교통동맥통창26례,무동맥류복발.결론 3D탄황권류체중건、류경중소기술전새치료전교통동맥류,병발증소、료효호,술후불수요장기복용항응약물,시일충안전、유효적치료방법.
Objective To investigate the technology and efficacy of aneurysm reconstruction and remodeling technique with 3D coils in the endovascular treatment of anterior communicating artery aneurysm.Methods The clinical data of 31 patients with anterior communicating artery aneurysms form September 2009 to September 2012 were retrospectively analyzed.Twenty one patients with ruptured aneurysms and 10 with unruptured aneurysms were diagnosed definitely by duel-source CT angiography (DSCTA) and digital subtract angiography (DSA).According to Hunt and Hess classification,17 cases were grade Ⅰ,12 cases were grade Ⅱ,2 cases were grade Ⅲ.All the patients underwent endovascular treatment of aneurysm reconstruction and remodeling technique with 3D coils.Results All the patients were endovascularly embolized by 3D-GDC and followed DSA and CT examinations.DSA showed that all the coils were in aneurysms and the parent arteries were clear.Among the 31 aneurysms,26 were completely embolized (83.87％) and 5 were partly embolized (16.13％).CT showed that no cerebral infarction or cerebral hemorrhage was found.At the time of discharge,the efficacy was assessed according to Glasgow outcome scale,26 cases (83.87％) had good prognoses,4 cases (12.9％) were lightly disabled and 1 case (3.22％) was severely disabled.Thirty-one patients were followed up for 6 months to 12 months (8.95 ± 4.08 months).Postoperative DSA or CT examinations showed that anterior communicating artery were slight stenosis in 5cases and were clear in 26 cases,no recurrence were found.Conclusions Aneurysm reconstruction and remodeling technique with 3D coils in the endovascular treatment of anterior communicating artery aneurysm is safe and effective with less complication,and long-term anticoagulant therapy is not needed after operation.