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Objective To compare the clinical effect of spring coil embolization under auxiliary technology and stent implantation spring coil embolization in treatment of intracranial aneurysms.Methods The medical records of 102 patients with intracranial aneurysms who were treated by endovascular embolization were retrospectively analyzed.These patients were divided into stent implantation spring coil embolization (n=58) and aux iliary spring coil embolization group(n=44) according to different treatment methods.The therapeutic effect of postoperative aneurysm embolization for patients of the two groups was evaluated.The postoperative hospitalization time,NIHSS score,ADL score and prognosis of patients in the two groups 6 months after treatment were compared.The incidence of complications of patients in the two groups was compared.Results There was no significant difference between the two groups about complete embolization rate,sub-total embolization rate and partial embolization rate after aneurysm surgery(72.73％,20.45％,6.82％ vs 68.97％,25.86％,5.17％)(P＞0.05).The postoperative hospitalization time of patients in the assistive coil embolization group (10.45±2.32) d was significantly less than that in the stent-assisted coil embolization (12.97±2.56) d (P＜0.05),but there was no significant difference in postoperative NIHSS score and ADL score between the two groups [(6.63±3.81),(60.12±9.80) vs (8.35±4.03),(59.63±9.47)(P＞0.05)].The recovery rate of patients in the assistive coil embolization group (68.18％) was significantly higher than that in the stent-assisted coil embolization group (55.17％) (P＜0.05),while the mortality rate (0％) was significantly lower than that in the stent-assisted coil embolization group (6.90％) (P＜0.05).The incidence of complications such as intraoperative cerebral vasospasm,postoperative gastrointestinal bleeding and postoperative cerebral infarction (9.09％,6.82％,4.55％) was significantly lower in the assistive coil embolization group than that in the stent-assisted coil embolization group (25.86％,20.69％,17.24％) (P＜0.05),while there was no significant difference in aneurysm recurrence rate between the two groups (13.64％ vs 10.34％)(P＞0.05).Conclusion Compared with stent implantation spring coil embolization,the spring coil embolization under auxiliary technology can significantly shorten the postoperative hospitalization time,improve the prognosis and reduce the incidence of postoperative complications.
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Objective To investigate the feasibility,safety and effectiveness of endovascular angioplasty with covered stent and embolization with spring coil in treating ruptured femoral artery pseudoaneurysm (FAP) associated with bleeding caused by injection of addictive drug.Methods The clinical data of 32 patients with ruptured FAP complicated by bleeding caused by injection of addictive drug,who were admitted to authors' hospital during the period from July 2012 to December 2015,were retrospectively analyzed.The average age of the patients was 36.5 years old,among them 25 patients were male (78.1％).Results Successful hemostasis was achieved in all 32 patients.The technical success rate of endovascular therapy was 100％,and no death occurred during perioperative period.Endovascular repair with covered stent was carried out in 25 patients (78.1％),embolization of femoral profound artery with spring coil in 9 patients (9.4％),and covered stent implantation together with embolization of femoral profound artery in 4 patients (12.5％).The patients were followed up for a mean of (17.5±11.6) months,with a follow-up rate being 93.8％ (30/32).The 3-year cumulative stent patency rate was 90.9％,and the 3-year overall survival rate was 91.3％.Conclusion For the treatment of ruptured FAP complicated by bleeding caused by injection of addictive drug,endovascular treatment is safe and effective with satisfactory mid-term clinical effect.This technique helps win the valuable time for critically ill patients to receive two-stage surgical debridement and vascular repair,as two-stage thorough debridement is an important means to control infection.
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Objective To investigate the effect of Solitaire stent combined with coils on endovascular embolization of intracranial wide-necked aneurysms.Methods Twenty-six cases with intracranial wide-necked aneurysms from June 2009 to December 2011 in the NO.264 Hospital of the Chinese People's Liberation Army were treated with Solitaire stent-assisted coils,and anticoagulation and antiplatelet therapy were done among peri operation period.The effect of endovascular embolization was evaluated after 3 months cerebral angiography.Results A total of 27 solitaire stent were used in the 26 patients,one of which used 2 stents.The stents were successfully put in place,and the placement effect were satisfaction.The immediate angiography showed that 24 cases were dense embolism,2 cases of subtotal embolization.Stent were placed at right position.Twenty-three patients were followed with DSA for 3 months,and no aneurysm evidence of recurrence was found.Conclusion Solitaire stent-assisted coil embolization of intracranial wide-necked aneurysms is simple to perform and embolism rate is high and the recurrence rate is low.
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Objective To investigate the effects,difficult points and technical key points of the interventional embolization in brain micro-aneurysms.Methods Retrospectively analyzed the material of the interventional embolization in 38 patients with brain micro-aneurysm.Results Twenty-six cases were treated with simple spring coil embolization technology,4 cases were treated with double micro-catheter embolization technic,2 cases were treated with embolization combining ballon assistive technic and 6 cases were treated with embolization combining stent assistive technic.All the 38 patients successfully embolized.The postoperative immediate cerebral angiogram to determine the degree of embolization:12 cases were 0 level,21 cases were 1 level and 5 cases were 2 level.The Rankin grade results showed that 0-1 score in 24 cases,2 scores in 10 cases,3-4 scores in 2 cases and 5 scores in 2 cases.Thirty-three patients were followed up for 6-12 months.No aneurysms recurred or re-raptured.Conclusions The spring coil embolization of brain micro-aneurysms is a feasible,safe and effective method,though the technics involved is difficulty.Selecting suitable embolization technics according to the characteristic of each micro-aneurysm can reduce the risk of operation,decrease complications and increase the successful rate.
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Objective To discuss the importance of balloon occlusion test before interventional treatment of the intracranial giant intemal carotid artery aneurysms and to sum up the nursing experience in assisting the procedure. Methods Proper perioperative nursing measures were carried out for 12 patients, who suffered from intracranial giant internal carotid artery aneurysm and underwent spring coil occlusion treatment. Nursing measures included mental care, observation of the vital signs, prevention of the complications, etc. Results Neither death nor exacerbation of the condition occurred in all the 12 patients. The patients were discharged from the hospital with a mean hospitalization of nine days. During a follow-up period ranged from 4 months to one year, seven patients had no disagreeable feeling, one patient complained of discomfort but no abnormality was found on follow-up DSA, and disappearance of the aneurysm was observed in 4 patients. Conclusion The monitoring of the vital signs, the prevention of the complications and the standard nursing care are the key points for ensuring a successful operation in treating intracranial giant intemal carotid artery aneurysms with spring coil occlusion.