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目的探讨球囊辅助电解可脱式弹簧圈栓塞治疗颅内宽颈动脉瘤的效果。方法采用全身麻醉,经股动脉入路,在数字减影血管造影(DSA)机监视下,先经导引导管放置不可脱球囊于载瘤动脉瘤开口处,然后在微导丝引导下,再置微导管头端于动脉瘤腔内。在行电解可脱式弹簧圈栓塞动脉瘤前,先在透视下用低浓度造影剂缓慢充盈动脉瘤开口处的球囊,使其暂时闭塞载瘤动脉与动脉瘤颈开口后,通过预先放置的微导管用合适的弹簧圈填塞动脉瘤囊,然后抽出球囊内的造影剂,恢复血流后行造影检查,确认所致弹簧圈稳妥后再解脱。如此反复进行,直到弹簧圈填塞满意为止。结果 10例宽颈动脉瘤患者在球囊辅助下弹簧圈均填塞满意,其中1例在栓塞左侧后交通动脉开口处宽颈动脉瘤结束撤出球囊复查造影时,发现半环弹簧圈突出载瘤动脉内,但无严重并发症发生。结论球囊辅助弹簧圈栓塞技术在扩展了栓塞动脉瘤适应证的同时,也有发生并发症的风险。但是,由于它是一种不开颅、创伤小、恢复快的技术操作,对宽颈动脉瘤来说,该项介入治疗技术仍是一种比较好的治疗方法。
Objective To investigate the effect of balloon-assisted electrolytic detachable coil embolization in the treatment of intracranial wide-necked aneurysms. Methods With general anesthesia and femoral artery approach, under the surveillance of digital subtraction angiography (DSA), the non-detachable balloon was placed in the opening of the aneurysm of the aneurysm through the guiding catheter, and then guided by the micro-guidewire, Micropipette tip again in the aneurysm cavity. Electrolytic detachable coil in the aneurysm before embolization, first with a low concentration of contrast medium slowly filling the aneurysm opening at the balloon, it temporarily occludes the parent artery and aneurysm neck opening, through the pre-placed Microcatheter with a suitable aneroid aneurysm sac filled capsule, and then withdraw the contrast agent within the balloon to restore blood flow after angiography to confirm that the resulting coil is safe and then relieved. This is repeated until the coil packing is satisfactory. Results In 10 patients with wide-necked aneurysms, the balloon-assisted coil was filled satisfactorily. One of the patients was found with a wide-necked aneurysm at the opening of the posterior communicating artery on the left side of the embolization, Carried within the artery, but no serious complications occurred. Conclusions Balloon-assisted coil embolization is an extension of embolic aneurysm indications as well as the risk of complications. However, because it is a non-craniotomy, less invasive and faster recovery procedure, this interventional treatment is still a good treatment for wide-necked aneurysms.