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目的探讨电解可脱性弹簧圈介入栓塞治疗急性破裂性颅内动脉瘤的并发症及其防治。方法在数字减影全脑血管造影(DSA)监视下,经股动脉,采用电解可脱性弹簧圈(GDC)栓塞治疗56例急性破裂性颅内动脉瘤患者。结果成功栓塞达100%有51例(92%),栓塞达90%以上4例(7%),栓塞达90%以下1例(1%)。全组手术死亡2例(3.57%);术中动脉瘤再破裂出血2例,载瘤动脉痉挛2例,GDC外逸3例,血栓形成2例,过度栓塞2例,术后并发高血压脑出血1例,并发症发生率19.6%,成功率80.23%。结论采用电解可脱式铂金螺旋圈(GDC)或微支架辅助GDC血管内栓塞是治疗颅内动脉瘤的一种微创、安全、有效的方法。在于术者对颅内动脉瘤和载瘤动脉解剖关系的正确认识,介入操作技术、术中、术后发生并发症的正确处理,栓塞材料的改进。
Objective To investigate the complications and its prevention and treatment of acute ruptured intracranial aneurysms treated by embolization with detachable coil. Methods Sixty - six patients with acute ruptured intracranial aneurysm were treated with digital subtraction whole cerebral angiography (DSA) and femoral artery occlusion with ECD (detachable coil). Results Successful embolization reached 51% (92%) in 100%, embolization reached more than 90% in 4 cases (7%), embolization reached below 90% in 1 case (1%). Two cases (3.57%) died of intraoperative aneurysm rupture, 2 cases of aneurysm rupture, 2 cases of tumor-bearing artery spasm, 3 cases of GDC escaping, 2 cases of thrombosis, 2 cases of excessive embolization, and postoperative complications of hypertensive brain Bleeding in 1 case, the complication rate was 19.6%, the success rate was 80.23%. Conclusions The use of electrolytic detachable platinum helical coil (GDC) or micro-scaffold to assist GDC in the treatment of intracranial aneurysms is a minimally invasive, safe and effective method. The correct understanding of the anatomy of the intracranial aneurysm and the parent artery of the surgeon involved interventional techniques, intraoperative and postoperative complications, and the improvement of embolic materials.