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目的 总结可脱式弹簧圈栓塞治疗颅内动脉瘤的临床经验。方法 1997年 1月～ 2 0 0 3年 2月对 178例动脉瘤采用可脱式弹簧圈栓塞治疗 ,其中 43例采用机械式可脱弹簧圈 (MDS)栓塞治疗 ,13 5例采用电解式可脱弹簧圈(GDC)栓塞治疗。结果 以 MDS栓塞组的 43例动脉瘤中 ,栓塞程度 10 0 %者 3 5例 (81% ) ;栓塞 90 %以上者 6例(14 % ) ;栓塞 90 %以下者 2例 (5% ) ,有 4例有弹簧圈短尾停留在载瘤动脉内 1～ 2 mm ,没出现临床症状。以 GDC栓塞组的 13 5例中 ,栓塞 10 0 % 12 6例 (93 % ) ;栓塞 90 %以上 8例 (6% ) ;栓塞 90 %以下 1例 (0 .7% )。全组手术死亡6例 (3 % ) ,术中出血 6例。 MDS组有 11例动脉瘤在栓塞后 3～ 3 2个月进行造影随访 ,其中 1例动脉瘤稍微变大 ,2例钨丝弹簧圈出现腐蚀溶解 ,动脉瘤复发 ,行再次栓塞。 GDC组有 15例栓塞后 6～ 17个月进行造影随访 ,均无变化。结论 MDS和 GDC都是颅内动脉瘤栓塞治疗的有效材料。GDC因其顺应性、可控性好 ,操作简单 ,安全可靠 ,效果好 ,是目前最主要的栓塞材料。
Objective To summarize the clinical experience of detachable coils in the treatment of intracranial aneurysms. Methods From January 1997 to February 2003, 178 cases of aneurysms were treated with detachable coil embolization, of which 43 cases were treated with mechanical detachable coil (MDS) embolization, and 135 cases were treated with electrolyzed GDC embolization. Results Among 43 aneurysms embolized with MDS, 35 (81%) had embolization of 10%, 6 (14%) embolized more than 90%, 2 (5%) embolized less than 90% There are 4 cases of short-haired coil stay in the parent artery within 1 ~ 2 mm, no clinical symptoms. Among 13 5 cases of GDC embolization group, 10 6% (93%) were embolized in 10%, 8 (6%) embolized 90% or more, and 1 case (0 .7%) embolized 90%. The whole group died of surgery in 6 cases (3%), 6 cases of intraoperative bleeding. In the MDS group, 11 cases of aneurysms were followed up 3 to 32 months after embolization. One case of aneurysm was slightly enlarged. Corrosion dissolution occurred in 2 cases of tungsten wire coil, the aneurysm recurred, and embolization was performed again. GDC group had 15 cases of embolization 6 to 17 months after angiography follow-up, no change. Conclusion Both MDS and GDC are effective materials for the treatment of intracranial aneurysm embolization. GDC because of its compliance, controllability, simple, safe, reliable, effective, is the most important embolic material.