颅内动脉瘤血管内治疗术中血管痉挛的处理

Treatment of cerebral vasospasm in the process of endovascular therapy

关键词:  颅内动脉瘤  介入治疗  血管痉挛

Key words:  intracranial aneurysm  cerebral vasospasm  interventional treatment

摘要:

［目的］探讨在血管内介入治疗过程中出现血管痉挛的可能原因及处理措施。［方法］回顾性分析颅内动脉瘤进行介入栓塞的病史，分析116例血管内治疗中22例出现明显血管痉挛的原因及术中治疗方法、治疗结果。［结果］22例血管内治疗术中出现血管痉挛患者经过撤除导管及动脉内持续灌注罂粟碱盐水或（和）尿激酶治疗后均恢复正常，未留后遗症。［结论］导管刺激血管壁是引起血管痉挛的主要原因，撤除导管及动脉内持续灌注罂粟碱盐水或（和）尿激酶能够有效使血管痉挛恢复正常。

Abstract:

［Objective］To discuss the reasons and the treatment of cerebral vasospasm in the process of endovascular therapy.［Methods］History of the treatment of aneurysms with aneurysms was retrospectively reviewed.Twenty-two patients with obviously cerebral vasospasm from 116 patients with endovascular therapy were included to analyze reasons,treatment and results.［Results］The 22 patients with obviously cerebral vasospasm in the endovascular therapy recovered well through valid treatments,with no sequelae.［Conclusion］The activation of vessel wall through the catheters was the main reason of cerebral vasospasm.Removing the catheter and infusing the papaverine and/or urokinase persistently through the arteries could recover cerebral vasospasm well.