EXPERIENCE OF MINIMALLY INVASIVE TREATMENT IN 520 PATIENTS WITH INTRACR ANIALANEURYSMS

来源 :Chinese Medical Sciences Journal | 被引量 : 0次 | 上传用户:jievons
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Objective.To summarize the experience of minim ally invasive treatment in 520patie nts with intracranial aneurysms on a retrospective study.Methods.The measures used in the treatment of520patients were reviewed in terms o f timing of surgery,induced-hypotensive anesthesia,b rain protection combined with temporal occlusion of the feeding artery,exter-nal drainage of CSF,dynamic monitoring of intracranial pressure,blood flow velocity,serum osmolality and CT scanning,anti-vasospasm therapy a s well as selected interventional en dovascular embolization of aneurysms.Results.Of the 520patients,485were treated with either direct clipping or endov ascular embolization and35patients were treated non-surgic ally.In 449patients undergoing dir ect clipping and 36undergoing endov ascu-lar embolization,intraoperative r upture of aneurysm occurred in 27(6.0%)and 0%,respectively.Death oc-curred in 13(2.6%),hemiplegia in 8(1.6%),and vegetative state in 2(0.4%).The operative mortality of direct clipping was 3.8%in 210patie nts before 1990and 1.8%in 275patien ts after 1990(36patients undergo-ing endovascular embolization,the operative mortality was 0%).Conclusion.The outcome of patients with intracranial aneurysms can be markedly impr oved and the opera-tive mortality can be lowered by mini mally invasive treatment. Objective.To summarize the experience of minim ally invasive treatment in 520patients with intracranial aneurysms on a retrospective study. Methods. The measures used in the treatment of 520patients were reviewed in terms of timing of surgery, induced-hypotensive anesthesia, b rain protection combined with temporal occlusion of the feeding artery, exter-nal drainage of CSF, dynamic monitoring of intracranial pressure, blood flow velocity, serum osmolality and CT scanning, anti-vasospasm therapy as well as selected interventional and dovascular embolization of aneurysms. Results. Of the 520patients , 485were treated with either direct clipping or endov ascular embolization and 35patients were treated non-surgic ally. 449patients undergoing dir ect clipping and 36undergoing endov ascu-lar embolization, intraoperative rupture of aneurysm occurred in 27 (6.0%) and 0%, respectively .Death oc-curred in 13 (2.6%), hemiplegia in 8 (1.6%), and vegetative state in 2 was 3.8% in 210patients in 1990 and 1.8% in 275patien ts after 1990 (36patients undergo-ing endovascular embolization, the operative mortality was 0%). Conclusion. The outcome of patients with intracranial aneurysms can be markedly impr oved and the opera-tive mortality can be reduced by mini mally invasive treatment.
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