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Endovascular Treatment of Intracranial Wide-necked Aneurysms

Author: WangHao
Tutor: WangFeng
School: Dalian Medical University
Course: Medical Imaging and Nuclear Medicine
Keywords: Intracranial aneurysm Wind-necked Interventional therapy
CLC: R730.5
Type: Master's thesis
Year: 2013
Downloads: 23
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Objective:The interventional treatment of operation is more difficult and risk inintracranial wide-necked relative to Narrow neck aneurysm,Use of stent assisted coilembolization, balloon assisted, double microcatheter technique and simple stentingtechnique has become the main method for treatment of wide-necked intracranialaneurysms, We evaluate the clinical effect of this thesis is to explore differentinterventional methods and the hospitalization, follow-up period.Method: Patients in the First Affiliated Hospital of Dalian Medical UniversityDepartment of interventional therapy from2004April to2012December a total of127cases of intracranial wide necked aneurysms were analyzed retrospectively, choosedifferent treatments according to the patient’s condition, aneurysm and cerebral vessels.Through outpatient, hospital review and telephone follow-up of patients, to understandthe general situation and living and working conditions of patients, all patients atdischarge and follow-up according to MRS score, curative effect comparison.Result:All patients were successfully carried out intervention, including6casesof patients with postoperative cerebral infarction;3cases of acute thrombosis in stentpatients formed within the thrombolytic treatment, including1cases of postoperativeday first aneurysms ruptured again death.The longest follow-up times are103months, the shortest3months. All of the127patients,112cases of effective follow-up,15cases lost follow-up, follow-up rate of88.2%. Among them7cases of death,1patients died of unknown causes in1patientsafter the first day of aneurysms ruptured again died, the rest of the death of5patientswithout any cause of death associated with interventional therapy. Comparison of MRSscore of112patients who were discharged with effective follow-up127patients, thetreatment effect is obvious, the normal life of most patients at different time after recovery.No anticoagulant therapy, all patients preoperative and postoperative aneurysmrupture antiplatelet caused by bleeding complications, only1patients because of acutethrombosis in stent forming thrombolytic treatment after the first postoperative dayaneurysms ruptured again death, but not clear whether thrombolysis and related.1patients with postoperative puncture site bleeding, given to hemostasis after bleedingstopped, consider and intraoperative heparinization. Result from hemostasismisconduct.4Intraoperative aneurysm rupture patients, to continue to tamponade aneurysmafter operation were successful, postoperative symptoms of different degree of coma,aphasia and other symptoms were improved, after discharge.1patients had nervecompression leads to the oculomotor nerve palsy,6months after the symptoms ofpartial remission after discharge.6patients after the operation of cerebral infarctioncaused slurred speech, limb weakness and other complications, many were improved invarying degrees after operation. All patients without femoral arteriovenous fistula,femoral nerve injury and pseudo aneurysm caused by puncture complications.Conclusion:Endovascular interventional treatment of intracranial wide-neckedaneurysms, through the evaluation of hospitalization and follow-up, the overall efficacy.Interventional therapy in different ways have their own advantages and disadvantages,should choose different treatments according to the patient’s condition, aneurysm andcerebral vessels. On the prevention and treatment of complications of interventionaltherapy should be emphasized, should pay attention to regular postoperative review,found the need for timely treatment of recurrence.

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