Analysis of the Causes, Prevention and Treatment of Hemorrhage During Coil Embolization for Intracranial Aneurysm_West China Medical Journal

Authors：

XIAO Bing ¹ , SONG Jianqiong ² , LIU Chunping ³ , LIU Yi ⁴ , CAI Hong ⁴ , CHEN Zhong. ⁴

1. Department of Interventional Radiology; 2. Department of Function; 3. Department of Neurology; 4. Department of Neurosurgery; Dazhou Central Hospital, Dazhou, Sichuan 635000, P. R. China;

Corresponding?author：

Keywords：

顱內動脈瘤; 彈簧圈; 栓塞; 術中出血

DOI：

10.7507/1002-0179.20130110

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目的　分析顱內動脈瘤彈簧圈栓塞治療術中出血的原因和防治對策。方法　回顧性分析2003年3月－2012年8月358例顱內動脈瘤采用彈簧圈栓塞治療患者，7例彈簧圈栓塞過程中出血，并繼續栓塞止血。2例為彈簧圈栓塞中造影僅見血流明顯變慢，術后CT證實的出血。術后對癥治療6例，開顱引流減壓3例。結果　9例術中破裂者中8例致密栓塞，1例部分栓塞。5例恢復好，1例一過性動眼神經麻痹，3例死于顱內高壓結論　術中出血與手中操作、動脈瘤形態和患者血管條件、血壓變化有關，繼續填塞及合理術中與后續治療可以挽救大部分患者生命。

Citation： XIAO Bing,SONG Jianqiong,LIU Chunping,LIU Yi,CAI Hong,CHEN Zhong.. Analysis of the Causes, Prevention and Treatment of Hemorrhage During Coil Embolization for Intracranial Aneurysm. West China Medical Journal, 2013, 28(3): 334-337. doi: 10.7507/1002-0179.20130110 Copy

1.	Molyneux A, Kerr R, Stratton I, et al. Internationgal Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patienta with ruptured intracranial aneurysms: a randomized trial[J]. Lancet, 2002, 360(9342): 1267-1274.
2.	Molyneux AJ, Kerr RS, Yu LM, et al. Internationgal Subarachnoid Aneurysm Trial (ISAT) Collaborative Group: internationgal subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patienta with ruptured intracranial aneurysms: a randomized comparison of effects on surviaval,dependency, seizures, rebleeding, subgroup, and aneurysms occlusion[J]. Lancet, 2005, 366(9488): 809-817.
3.	Brisman J L, Niimi Y, Song J K, et al. Aneurysmal rupture during coiling:low incidence and good outcomes at a single large volume center[J]. Neurosurgery, 2008, 62 (6Suppl 3): 1538-1551.
4.	鄧其峻, 廖旭興, 鐘偉健, 等.顱內動脈瘤血管內介入栓塞治療術中出血的防治[J]. 廣東醫學, 2011, 32(1): 90-92.
5.	潘奇, 劉建民, 許弈, 等. 顱內破裂動脈瘤栓塞術后早期破裂再出血危險因素分析[J]. 介入放射學雜志, 2010, 19(2): 95-100.
6.	李明華, 劉建民, 許奕, 等. 顱內動脈瘤的電解脫彈簧圈栓塞治療[J]. 上海醫學, 2000, 23(9): 535-539.
7.	李鐵林. 腦動脈瘤血管內栓塞治療的若干經驗[J]. 神經精神疾病雜志, 2001, 27(3): 235-236.
8.	Batjer H, Semson D. Intraoperative aneurismal rupture: incidence, outcome and suggestions for surgical management[J]. Neurosurgery, 1986, 18(4): 701.

1. 　Molyneux A, Kerr R, Stratton I, et al. Internationgal Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patienta with ruptured intracranial aneurysms: a randomized trial[J]. Lancet, 2002, 360(9342): 1267-1274.
2. 　Molyneux AJ, Kerr RS, Yu LM, et al. Internationgal Subarachnoid Aneurysm Trial (ISAT) Collaborative Group: internationgal subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patienta with ruptured intracranial aneurysms: a randomized comparison of effects on surviaval,dependency, seizures, rebleeding, subgroup, and aneurysms occlusion[J]. Lancet, 2005, 366(9488): 809-817.
3. 　Brisman J L, Niimi Y, Song J K, et al. Aneurysmal rupture during coiling:low incidence and good outcomes at a single large volume center[J]. Neurosurgery, 2008, 62 (6Suppl 3): 1538-1551.
4. 　鄧其峻, 廖旭興, 鐘偉健, 等.顱內動脈瘤血管內介入栓塞治療術中出血的防治[J]. 廣東醫學, 2011, 32(1): 90-92.
5. 　潘奇, 劉建民, 許弈, 等. 顱內破裂動脈瘤栓塞術后早期破裂再出血危險因素分析[J]. 介入放射學雜志, 2010, 19(2): 95-100.
6. 　李明華, 劉建民, 許奕, 等. 顱內動脈瘤的電解脫彈簧圈栓塞治療[J]. 上海醫學, 2000, 23(9): 535-539.
7. 　李鐵林. 腦動脈瘤血管內栓塞治療的若干經驗[J]. 神經精神疾病雜志, 2001, 27(3): 235-236.
8. 　Batjer H, Semson D. Intraoperative aneurismal rupture: incidence, outcome and suggestions for surgical management[J]. Neurosurgery, 1986, 18(4): 701.

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Analysis of the Causes, Prevention and Treatment of Hemorrhage During Coil Embolization for Intracranial Aneurysm

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