Abstract
目的 探讨破裂动脉瘤在电解脱弹簧圈(Guglielmi detachable coil,GDC)栓塞术中再次破裂的可能性及其相应措施.方法159例颅内动脉瘤施行GDC栓塞时,发生术中再次破裂7例.女5例,男2例,平均年龄46.9岁.7例中微导丝原性破裂1例,弹簧丝原性破裂3例,微导管原性破裂2例,弹簧圈填塞过度性破裂1例.结果3例弹簧丝原性破裂和2例微导管原性破裂均施行GDC继续填塞或调整微导管位置后继续填塞,直至瘤腔致密填塞.该5例中4例术后完全康复,1例残留一侧下肢不灵便;1例微导丝原性破裂和1例弹簧圈过度填塞性破裂,因术中出血过多致死亡.结论颅内动脉瘤GDC栓塞中发生动脉瘤破裂难以避免,操作者经验与发生率成反比,材料选择合适可降低其发生率,破裂发生后继续GDC填塞可达到完全填塞、愈复。
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