双微导管栓塞治疗颅内动脉瘤的研究进展
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摘要
颅内动脉瘤破裂出血、高血压病脑出血、脑梗塞为我国三大脑血管意外。开颅夹闭动脉瘤蒂和血管内介入栓塞是当下治疗颅内动脉瘤的两种积极手段。双微导管栓塞颅内动脉瘤技术是用两根微导管分别进入瘤腔,交替填入可脱弹簧圈,完全栓塞动脉瘤的一种技术方法。在过去的十几年里,针对不良形态的动脉瘤,如分叶状、宽颈以及瘤底合并主要分支,它们的介入治疗具有相当大的困难,虽然,球囊和支架辅助技术相当大程度改进了血管内的治疗手段,但其仍受限于弯曲血管及较小的远端分支。双微导管技术正是在这里发挥了它的优势作用。笔者现就目前双微导管栓塞治疗颅内动脉瘤的临床应用作一综述。
The rupture and hemorrhage of intracranial aneurysm,hypertensive cerebral hemorrhage and cerebral infarction are three cerebral vascular accidents in China. The pedicle of craniotomy and intravascular embolization are two active methods for the treatment of intracranial aneurysms. Double microcatheter embolization for intracranial aneurysms is a technique for completely embolization of aneurysms with two microtubes entering the lumen cavity and alternately filling detachable coils. In the past ten years,the bad aneurysm morphology,such as lobular,wide neck aneurysm and bottom with main branches,it is very difficult to treat. Although their intervention,balloon and stent assisted technique considerably improved intravascular treatment,it is still limited by curved vessels and smaller distal branches. The dual microcatheter technology is here to play its advantage. The clinical application of double microcatheter embolization in the treatment of intracranial aneurysms is reviewed.
The rupture and hemorrhage of intracranial aneurysm,hypertensive cerebral hemorrhage and cerebral infarction are three cerebral vascular accidents in China. The pedicle of craniotomy and intravascular embolization are two active methods for the treatment of intracranial aneurysms. Double microcatheter embolization for intracranial aneurysms is a technique for completely embolization of aneurysms with two microtubes entering the lumen cavity and alternately filling detachable coils. In the past ten years,the bad aneurysm morphology,such as lobular,wide neck aneurysm and bottom with main branches,it is very difficult to treat. Although their intervention,balloon and stent assisted technique considerably improved intravascular treatment,it is still limited by curved vessels and smaller distal branches. The dual microcatheter technology is here to play its advantage. The clinical application of double microcatheter embolization in the treatment of intracranial aneurysms is reviewed.
引文
[1]史耕郡,林柏和,于如江.Orbit三维弹簧圈在颅内动脉瘤栓塞中的临床应用[J].航空航天医学杂志,2013,24(5):554-555.
[2]陈永汉,樊爱华,李宗豪,等.64排螺旋CTA对颅内动脉瘤的评估效果[J].中华临床医师杂志(电子版),2012,6(2):501-502.
[3]Durst CR,Starke RM,Gaughen JR Jr,et al.Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms[J].JNeurosurg,2014,121(5):1093-101.
[4]庞志宏,王文犀,郭立刚.双微导管技术栓塞治疗颅内动脉瘤[J].中国临床神经外科杂志,2015,20(3):177-178.
[5]倪立新,吕学海,袁建新.短暂性脑缺血发作与颅内-外血管狭窄的关系[J].河北医药,2009,31(15):1907-1909.
[6]田硕,杨旭.3D-CTA在颅内破裂动脉瘤早期诊断中的应用[J].中南医学科学杂志,2013,41(5):512-513,525.
[7]庞志宏,王新亮,王文犀.双导管技术栓塞治疗颅内动脉瘤[J].局解手术杂志,2015,(2):179-181.
[8]尹龙,黄楹,魏铭,等.双微导管技术栓塞复杂颅内动脉瘤[J].中国现代神经疾病杂志,2013,13(3):216-221.
[9]张帅,吕明.双微导管弹簧圈保护技术栓塞颅内宽颈小动脉瘤三例[J].中国脑血管病杂志,2015,12(7):366-368.
[10]Starke RM,Durst CR,Evans A,et al.Endovascular treatment of unruptured wide-necked intracranial aneurysms:comparison of dualmicrocatheter technique and stent-assisted coil embolization[J].J Neurointerv Surg,2015,7(4):256-61.
[11]梁世行,刘成辉,陈旭,等.影像学判断标准及栓塞体积比指导颅内动脉瘤栓塞治疗效果比较[J].中国微侵袭神经外科杂志,2015,20(9):396-398.
[12]王裕勤,吴佳源,段世英,等.Rebirth pro血栓抽吸导管在急诊经皮冠状动脉介入治疗中应用的临床研究[J].临床内科杂志,2016,33(10):697-699.
[13]Durst CR,Starke RM,Gaughen JR Jr,et al.Singlecenter experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms[J].J Neurosurg,2014,121(5):1093-101.
[14]夏吉勇.水解微弹簧圈血管内栓塞治疗颅内动脉瘤的临床研究[J].北京医学,2008,30(2):71.
[15]邱传珍,杨少春,刘鹏,等.24例相对宽颈前交通动脉瘤的血管内治疗[J].武汉大学学报(医学版),2013,34(1):136-138.
[16]Yoon PH,Lee JW,Lee YH,et al.Dual microcatheter coil embolization of acutely ruptured wide-necked intracranial aneurysms[J].Interv Neuroradiol,2017,23(5):477-484.
[17]Yin L,Wei M,Ren H.Double microcatheter technique for coil embolization of small aneurysms with unfavorable configurations:A comparative study of the aneurysms that are≤3 mm or>3 mm[J].Interv Neuroradiol,2016,22(2):158-64.
[18]Wei M,Ren H,Yin L.The combinational use of dual microcatheter technique and new hypersoft helical coil for endovascular treatment of tiny intracranial aneurysm with difficult geometry[J].Interv Neuroradiol,2016,22(1):18-25.
[19]Spiotta AM,Chaudry MI,Turk AS,et al.Initial experience with the PulseRider for the treatment of bifurcation aneurysms:report of first three cases in the USA[J].J Neurointerv Surg,2016,8(2):186-9.
[20]张向艳,左书浩,李建华,等.采用双微导管技术血管内治疗颅内宽颈动脉瘤[J].河北医药,2011,33(18):2795-2796.
[2]陈永汉,樊爱华,李宗豪,等.64排螺旋CTA对颅内动脉瘤的评估效果[J].中华临床医师杂志(电子版),2012,6(2):501-502.
[3]Durst CR,Starke RM,Gaughen JR Jr,et al.Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms[J].JNeurosurg,2014,121(5):1093-101.
[4]庞志宏,王文犀,郭立刚.双微导管技术栓塞治疗颅内动脉瘤[J].中国临床神经外科杂志,2015,20(3):177-178.
[5]倪立新,吕学海,袁建新.短暂性脑缺血发作与颅内-外血管狭窄的关系[J].河北医药,2009,31(15):1907-1909.
[6]田硕,杨旭.3D-CTA在颅内破裂动脉瘤早期诊断中的应用[J].中南医学科学杂志,2013,41(5):512-513,525.
[7]庞志宏,王新亮,王文犀.双导管技术栓塞治疗颅内动脉瘤[J].局解手术杂志,2015,(2):179-181.
[8]尹龙,黄楹,魏铭,等.双微导管技术栓塞复杂颅内动脉瘤[J].中国现代神经疾病杂志,2013,13(3):216-221.
[9]张帅,吕明.双微导管弹簧圈保护技术栓塞颅内宽颈小动脉瘤三例[J].中国脑血管病杂志,2015,12(7):366-368.
[10]Starke RM,Durst CR,Evans A,et al.Endovascular treatment of unruptured wide-necked intracranial aneurysms:comparison of dualmicrocatheter technique and stent-assisted coil embolization[J].J Neurointerv Surg,2015,7(4):256-61.
[11]梁世行,刘成辉,陈旭,等.影像学判断标准及栓塞体积比指导颅内动脉瘤栓塞治疗效果比较[J].中国微侵袭神经外科杂志,2015,20(9):396-398.
[12]王裕勤,吴佳源,段世英,等.Rebirth pro血栓抽吸导管在急诊经皮冠状动脉介入治疗中应用的临床研究[J].临床内科杂志,2016,33(10):697-699.
[13]Durst CR,Starke RM,Gaughen JR Jr,et al.Singlecenter experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms[J].J Neurosurg,2014,121(5):1093-101.
[14]夏吉勇.水解微弹簧圈血管内栓塞治疗颅内动脉瘤的临床研究[J].北京医学,2008,30(2):71.
[15]邱传珍,杨少春,刘鹏,等.24例相对宽颈前交通动脉瘤的血管内治疗[J].武汉大学学报(医学版),2013,34(1):136-138.
[16]Yoon PH,Lee JW,Lee YH,et al.Dual microcatheter coil embolization of acutely ruptured wide-necked intracranial aneurysms[J].Interv Neuroradiol,2017,23(5):477-484.
[17]Yin L,Wei M,Ren H.Double microcatheter technique for coil embolization of small aneurysms with unfavorable configurations:A comparative study of the aneurysms that are≤3 mm or>3 mm[J].Interv Neuroradiol,2016,22(2):158-64.
[18]Wei M,Ren H,Yin L.The combinational use of dual microcatheter technique and new hypersoft helical coil for endovascular treatment of tiny intracranial aneurysm with difficult geometry[J].Interv Neuroradiol,2016,22(1):18-25.
[19]Spiotta AM,Chaudry MI,Turk AS,et al.Initial experience with the PulseRider for the treatment of bifurcation aneurysms:report of first three cases in the USA[J].J Neurointerv Surg,2016,8(2):186-9.
[20]张向艳,左书浩,李建华,等.采用双微导管技术血管内治疗颅内宽颈动脉瘤[J].河北医药,2011,33(18):2795-2796.