栓塞治疗颅内动脉瘤的并发症及处理方法分析

目的:分析栓塞治疗颅内动脉瘤过程中并发症的发生原因及处理方法。方法:回顾性分析微弹簧圈栓塞治疗的97例颅内动脉瘤患者的临床资料,包括性别、年龄、Hunt-Hess分级,对住院患者进行术前整体状况评估。影像学检查主要记录动脉瘤的位置、瘤体长度和瘤颈宽度,测量其长宽比例。血管内介入手术治疗观察各种介入治疗方法以及相关并发症。结果:本组97例颅内动脉瘤患者中,男44例、女53例,男性平均年龄51.3岁,女性平均年龄46.7岁,男女共同平均年龄48.7岁。颈内动脉-后交通支及其附近动脉瘤51个,前交通动脉和大脑前动脉29个,大脑中动脉11个,椎-基底动脉系统6个,所用到的栓塞材料包括各种弹簧圈、颅内支架、不可脱球囊等。97例中15例出现并发症(15.5%),动脉瘤破裂出血4例,术中发生血管痉挛3例,血栓形成或血栓性栓塞5例,3例死亡。结论:栓塞治疗颅内动脉瘤过程中最主要并发症包括动脉瘤破裂、栓塞和血栓形成、血管痉挛等,术前评估、术中谨慎操作以及正确及时的处理能够降低栓塞治疗颅内动脉瘤的并发症。

Analysis of the Complications during Interventional Treatments of Intracranial Aneurysms and their Treatment

Objective： To analyze the reasons and treatments of complications during the inlracranial aneurysm embolization. Methods： A retrospective analysis of coiling embolized intracranial aneurysms, The clinical data included gender, age, Hunt and Hess grading scale, to assess the patients＇ condition before treating. The imaging reported the site, length, width and length/width ratio of aneurysms. Recording various methods of endovascular treatment and assistance.recording methods and associated complications in interventional treatment. Results＂ In clinical data of 97 patients with intracranial aneurysm, male 44 cases and female 53 cases, the average age of male is 51.3 years old and female is 46.7 years old, the average age of male and female is 48.7 years old. According to the classification of location, ICA（Internal Carotid Artery）-PcoA（Posterior Cormnunicating Artery） 51 cases, AcoA（Anterior Cormnunicating Artery） and ACA （Anterior Cerebral Artery）29 cases, MCA（Middle Cerebral Artery） 11 cases, BA（Basilar artery）-VA（Vertebral artery） 6 cases; Embolism stuff includes various coils, intracranial stent, undetachable balloon. 15 of 97 cases complications （15.5 %）, including aneurysm bleeding in 4 cases, intraoperation vasospasm 3 cases, thrombosis or thrombotic embolization 5 cases, died 3 cases. Conclusion： The main complications of coiling embolized intracranial aneurysms included aneurysm rupture, thrombogenesis and embolization, vasospasm, etc, preoperative assessment, prudent operation, correct and timely treatments could reduce the intraoperation complications and adverse consequences.