以高尼米可分離線圈栓塞顱內血管動脈瘤－四病例報告

Endovascular Embolization to Treat Cerebral Aneurysms with Guglielmi Detachable Coil: A Report of Four Cases

李明哲(Ming-Che Lee) ； 嚴寶勝(Pao-Sheng Yen) ； 姚俊旭(Chun-Hsu Yao) ； 楊良友(Albert D. Yang) ； 林清澤(Jackson C. T. Lin)

《The Changhua Journal of Medicine》 6卷4期 (2001/10) Pp. 261-266

摘要

腦血管動脈瘤為一高危險性的疾病，傳統的治療方法皆以外科手術為主要的治療方式。但動脈瘤若位於手術困難的解剖位置（如後顱窩）常挑戰外科手術在這些方面的可行性及成功率，然而經血管顱內動脈瘤栓塞術則可應用於合適之患者。藉由血管攝影先了解動脈瘤的解剖形狀、位置、大小及其內徑與動脈瘤頸部之比例，再由微導管到達動脈瘤位置後，依動脈瘤的大小選擇可分離線圈之尺寸，將線圈充填入動脈瘤，經確認位置無誤再施以電力分離。而若位置不適當，在施加電力分離前，則白金線圈可回抽重新置放至理想位置，直至將動脈瘤栓塞，以防止動脈瘤破裂出血造成危險。此治療方式的高成功率及安全性，有效地解決了外科手術的不適應症及避免手術困難所易導致的失敗。

關鍵字

動脈瘤 ； 經血管治療 ； 可分離線圈 ； 栓塞

並列摘要

For cerebral aneurysms, surgical operation is the treatment of choice except in circumstances such as difficult surgical access, poor clinical condition, and a prediction of surgical failure.
Under these conditions, using GDC embolization to treat cerebral aneurysms is indicated. Angiography is initially performed to evaluate the size, location and anatomic relationship of the aneurysm with surrounding vessels. A Tracker micro-catheter is used to approach the aneurysm and then place a coil of the appropriate size into it. Once the coil is in proper position within the aneurysm, a direct current is applied to the proximal end of the delivery wire and the coil is detached. The detachable coil will embolize the aneurysm and prevent it from rebleeding or further rupture. Another advantage of this method is that the coil can be repositioned at the best location within the aneurysm before permanent detachment.

並列關鍵字

Aneurysm ； endovascular treatment ； detachable coil ； embolization