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Clinical Analysis of Endovascular Trentment of Middle Cerebral Artery Bifurcation Aneurysms at Front Segment

Author: ZhangLei
Tutor: XiongZuo
School: Taishan Medical College
Course: Neurology
Keywords: Intracranial aneurysm Middle cerebral artery Stent Endovascular treatment
CLC: R739.41
Type: Master's thesis
Year: 2012
Downloads: 16
Quote: 0
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Abstract


The traditional treatment of intracranial aneurysms is a craniotomy, gradually gainedpopularity in recent years, endovascular interventional treatment. In particular, publishedin2002, the International Subarachnoid Hemorrhage Aneurysm Trial (InternationalSubarachnoid Aneurysm Trail, ISAT) results showed that: compared with surgicaltreatment, endovascular coil embolization of relative risk and absolute risk were reducedby22.6%and6.9%; one year after the results of both disability and mortality were23.7%and30.6%, embolization therapy more effective than surgical treatment, rebleeding ratedifference was not significant[8], this authority report is certainly involved in treatment.Interventional treatment of its damage, and rapid recovery features to solve many of theproblems of the craniotomy.The purpose of this retrospective study is to evaluate thefeasibility, safety and efficacy of endovascular treatment of middle cerebral arterybifurcation aneurysms at front segment.The clinical data of15patients with20middle cerebral artery bifurcation aneurysmsat front segment treated endovascularly in First People’s Hospital of Jining City and JinanMilitary General Hospital from August2010to December2011were analyzedretrospectively. General anesthesia and Seldinger technique were used via femoral arterypuncturing, stenting alone, coiling alone or stents in combination with coils. In all patientswere heparinized. Underwent conventional and rotational DSA examination of bloodvessels of the aneurysm parallel three-dimensional reconstructionAll the aneurysms were treated successfully using endovascular embolizationtreatment, including coiling alone for5cases, stent alone for3case, and stents incombination with coils for7cases. The aneurysms were densely packed in5casesimmediately after surgery, aneurysmal necks developed in4cases, and aneurysm bodiesdeveloped in3cases. The contrast agent in aneurysm of3cases obviously detained immediately after stenting alone. No intraoperative aneurysm rupture was observed. Theprocedure-related complication occurred in1case (infarction in left the basal gangliaregion, the right limb muscle strength0). The modified Rankin Scale (mRS) score atdischarge was4. The mRS score was2after6-month follow-up. Seven patients receivedDSA reexamination (3-8months, mean,6.1months),2of them had aneurysmrecanalization and were retreated, and the aneurysms were densely packed;15patientswere followed up for3to20months (mean,7.7months), neither new neurologicalsymptoms nor aneurysm rerupture were seen. Combined with the results of treatment inthis group, while taking into account the minimally invasive embolization,we believe thatthe treatment of middle cerebral artery bifurcation preceding aneurysm endovasculartreatment will be increasingly inclined to.Therefore, we believe that Endovascular embolization treatment of middle cerebralartery bifurcation aneurysms at front segment is technically feasible, its safety is high,however, its long-term efficacy needs to be further followed up.

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