脳動脈瘤コイル塞栓術の有用性および限界

概要

論文の詳細を見る
We retrospectively analyzed the results of our aneurysm cases treated with Guglielmi detachable coils (GDCs), and evaluated the efficacy and safety of this technique. Between March 1997 and December 2000, 281 aneurysms in 258 patients were treated with GDCs. Of the 258 patients 128 aneurysms in 121 patients were ruptured, and 153 aneurysms in 137 patients were unruptured. The mortality and morbidity rate of ruptured aneurysms were 1.7% and 6.6%, respectively. The mortality and morbidity rate of unruptured ones were 0% and 3.6%, respectively. Aneurysm perforation was found in 6.3% of ruptured aneurysms and 6.5% of unruptured ones. Ischemic complications were found in 10.9% of ruptured aneurysms and 17.0% of unruptured ones. However, these complications have been decreasing year by year. Rebleeding occurred in 7 aneurysms (5.4%) (6 large and 1 small aneurysms) after embolization of ruptured aneurysms. No bleeding was found in unruptured aneurysms. Long-term stability of embolized aneurysm was significantly correlated with the size of aneurysm and volume embolization rate. Small aneurysms had a higher volume embolization rate and higher stability after embolization. In conclusion, GDC embolization was a safe and effective method for the treatment of small aneurysms, but the indication of this technique should be considered carefully for the treatment of large aneurysms.
日本脳卒中の外科学会の論文
2002-01-31