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Endovascular Treatment of Refractory Intracranial Aneurysms

Author: WangZhenQiu
Tutor: ZhangJian
School: Dalian Medical University
Course: Neurosurgery
Keywords: Refractory intracranial aneurysms Interventional treatment Embolism
CLC: R739.41
Type: Master's thesis
Year: 2013
Downloads: 9
Quote: 0
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ntracranial aneurysm is the first cause of subarachnoid hemorrhage after cerebralthrombosis and cerebral hemorrhage, cerebrovascular accident, ranked third, isrecognized worldwide as a great danger of cerebrovasculardisease, with high mortalityand morbidity.With the rapid development of endovascular treatment of intracranialaneurysms cure rate gradually increased, but the refractory intracranial aneurysmendovascular treatment remains challenging.Objective:Analyzed retrospectively by simply stent thrombosis, simple coilembolization and stent combined with coil the medical records of the treatment ofrefractory intracranial aneurysms, outlined three methods of operating points andconsiderations, and intraoperative complications and postoperativedisease treatment andprevention, and to assess the long-term and short-term efficacy of the three. Explore thefactors that affect aneurysm recurrence after embolization. Sum up experience, to laythe foundation for future clinical treatment.Method:Summary Review our department treatment of the medical records of26patients with refractory intracranial aneurysms, including the patient’s gender, age, onsetof clinical symptoms, preoperative Hunt-Hess grade, imaging findings, aneurysmmorphology, size,parts, embolization methods and materials, intraoperative andpostoperative complications, and postoperative clinical follow-up.Result:26patients with refractory intracranial aneurysms were successfullyembolism, no failure case. The immediate effect of embolization induction: completeocclusion in22cases (85%) of the tumor cavity, subtotal plug1(4%), incompleteembolization in3patients (11%). Simple Guglielmi detachable coil incompleteembolization cases, two cases of simple bracket the parent artery embolization; stentcoil embolization of23cases, including complete occlusion in22cases, subtotalembolization.26patients were followed up: the modified Rankin rating:021cases(84%),1-2in3cases (15%)3-51(1%),1died. Simple stent thrombosis after11daysafter aneurysm rupture the one cases25days after the rupture of the aneurysm; the coil alone does not fully embolism,7days after aneurysm rupture; stent-assisted coilembolization, aneurysm cases of the disease no longer exists. The aneurysm-yearfollow-up without recurrence in23cases (88%). According to statistics, the highrecurrence rate for simple coil embolization and simple application of the stent in thetreatment of intracranial aneurysms.Conclusion: Endovascular treatment of intracranial aneurysms is a minimallyinvasive, low-risk, patient recovery time is short, the advantages, especially forrefractory intracranial aneurysm, is a safe and reliable method. Stent-assisted coiltreatment of for refractory intracranial aneurysms, the efficacy of the best embolization.According to the type to select the type of aneurysm embolization materials andmethods will directly affect the effect of embolism and prognosis.

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CLC: > Medicine, health > Oncology > Nervous system tumors > Intracranial tumors and brain tumors
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