当施設における未破裂脳動脈瘤の治療選択とその成績(<特集>未破裂脳動脈瘤の治療選択)

概要

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In selecting a treatment method at our hospital for unruptured cerebral aneurysm, we inform the patient of craniotomy and transcatheter embolization by GDC and allow the patient to choose between the procedures when it is determined that GDC embolization is likely to achieve complete or nearly complete occlusion. This analysis is aimed at clarifying the treatment results of unruptured cerebral aneurysm after GDC was introduced at our hospital. The subjects were selected from 207 cases of craniotomy and 49 cases of transcatheter embolization by GDC performed between January 1998 and December 2001. We analyzed their morbidity (MB) and mortality (MT) for treatment evaluation. In 207 craniotomy cases, MT, transient MB and permanent MB were 0%, 4.5% and 2.2%, respectively. In transcatheter embolization, MT, transient MB and permanent MB were 0%, 4.0% and 0%, respectively. The overall result of the analysis showed MT 0%, transient MB 4.4% and permanent MB 1.8%, respectively. The surgery results based on our treatment guidelines were mostly excellent. In selecting a treatment procedure for unruptured cerebral aneurysm, it is important to focus on obtaining sufficient occlusion and ensuring safety. When applying both craniotomy and transcatheter embolization, the patient should be fully informed and agree to the procedures.
日本脳卒中の外科学会の論文
2003-05-31