嚢状脳動脈瘤に対する脳血管内手術手技による合併症についての検討

概要

論文の詳細を見る
We retrospectively analyzed the complication of embolization for cerebral saccular aneurysms in 139 cases. Sixty-six cases were ruptured aneurysms and 73 cases were unruptured aneurysms. There were 48 men and 91 women, ranging in age from 26 to 90 years (mean age 62.1 years). The clinical Hunt and Hess grades of 66 ruptured cases were as follows: Grade I, 22 cases; Grade II, 7 cases; Grade III, 5 cases; Grade IV, 13 cases and Grade V, 19 cases. The symptoms in 73 unruptured cases were craniai nerve dysfunction in 19 cases and no symptoms in 54 cases. The 114 cases used GDC, 18 cases used IDC and 7 cases used Cook's detachable coil for embolization. The mean follow-up period was 17 months. There were complications in 11 of our cases (7.9%): bleeding complication in 5 cases (3.7%) and embolic complication in 6 cases (4.3%). The bleeding complications occurred during embolization. The embolic complications were infarction in 4 cases (2.9%) and TIA in 2 cases (1.4%). Permanent morbidity occurred in 6 cases (4.3%) and mortality in 1 (0.72%). In conclusion, it is important that embolization of aneurysms be done carefully and blood pressure be controlled at operation to prevent bleeding complications. It is essential that anti-coagulation therapy be done at embolization or after embolization for at least 6 months.
日本脳卒中の外科学会の論文
2005-03-31