Analysis of complications and strategies of prevention and treatment in endovascular embolotherapy of ruptured intracranial aneurysm
10.3760/cma.j.issn.1671-8925.2008.04.022
- VernacularTitle:破裂后颅内动脉瘤介入手术相关并发症分析与防治对策
- Author:
Xi-Xiang YU
1
;
Shun-Kai ZHANG
;
Tong-Guo SI
;
Yi NAN
;
Xing-Yang YI
;
An-Sheng WU
;
Zhen-Jing SHI
;
Guo-Qing ZHU
Author Information
1. 温州医学院附属第三医院
- Keywords:
Intracranial aneurysms;
Indovascular embolotherapy;
Complications;
Countermeasures
- From:
Chinese Journal of Neuromedicine
2008;7(4):406-409
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the cause, prevention and treatment of complications related to endovascular embolotherapy for ruptured intracranial aneurysms. Methods Sixty-eight patients with ruptured intracranial aneurysms received early endovascular embolization. Intraoperatively, artery spasm was relieved by papaverine infusion through microcatheter or balloon dilatation; parent artery occlusion by coils was treated by anticoagulation or antiplatelet treatment; ruptured aneurysms were embolized using mixed heparin; arterial thrombosis after embolization was ameliorated by the micro-catheter infusion of r-tPA thrombolytic. Results In the 68 cases, 8 cases suffered from complications, accounting for 11.77%. Among them, 1 case of extensive spasm of middle cerebral artery developed cerebral infarction and mild hemiplegia; 2 cases of localized spasm were improved well without sequelae; 1 case in which partial coils entered middle cerebral artery achieved a satisfied therapeutic outcome without infarction; 1 case with cerebral infarction due to coil dropping and 1 case with aneurysm rupture during operation received secondary embolotherapy without adverse consequences; one week after operation, 1 case died from aneurysm re-rupture; 1 case had hemiplegia owing to massive cerebral infarction. Conclusions It will do much benefit to secure the success of the operation by displaying the location, shape and size of the aneurysms as well as the relationship with the parent artery. Moreover, the proper choice of coils and well mastering of operative skills can decrease the incidence of complications, and adequate and prompt treatment of intraoperative complications can improve the prognosis of the patients obviously.
