破裂和未破裂颅内动脉瘤栓塞治疗实践标准

作     者：Athos Patsalides Ketan R Bulsara Daniel P Hsu Todd Abruzzo Sandm Narayanan Mahesh V Jayaraman Gary Duckwiler Richard Paul Klucznik Michael Kelly Joshua A Hirsch Don Heck Jeffery Stmshine Don Frei Michael J Alexander Huy M Do Philip M Meyers 邱忠明(译) 张君(译) 徐格林(译) 

作者机构：From the Department of Neurological Sure'y New York Presbyterian Hospital weill Comell Medical College New York New York USA Department of Neurosurgery Yale University School of Medicine New Haven Connecticut USA Department of Interventional Neuroradiology University Hospitals Case Medical Center Cleveland Ohio USA Department of Neurosurgery University of Cincinnati Cincinnati Ohio USA Departments of Neurosurgmy & Neurology Wayne State University School of Medicine Detroit Michigan USA Departments of Diagaostic Imaging mad Neurosurgery Warren Alpert School of Medicine at Brown University Providence Rhode Island USA Department of Radiological Sciences UCLA Medical Center Los Angeles California USA Department of Nenroradiology Methodist Hospital Houston Texas USA Department of Neurosurgery Royal University Hospital University of Saskatchewan Saskatoon Saskatchewan Canada NeuroEndovascular Program Massachusetts General Hospital Boston Massachusetts USA Department of Radiology Forsyth Medical Center Winston Salem North Carolina USA Department of Radiology University Hospitals Case Medical Center Cleveland Ohio USA Department of Interventional Neuroradiology Radiology Imaging Associates Engiewood Colorado USA Department of Neurosurg:ry Cedars-Sinai Medical Center Los Angeles California USA Department of Radiology and Neurosurgery Stanford University Medical Center Stanford California USA Department of Radiology and Neurological Surgery Columbia University New York New York USA 南京军区南京总医院神经内科210002 

出 版 物：《国际脑血管病杂志》 (International Journal of Cerebrovascular Diseases)

年 卷 期：2013年第21卷第6期

页      码：418-424页

摘      要：弹簧圈栓塞最初被设计并经美国食品药品监督管理局批准用于治疗显微外科手术夹闭风险高的脑动脉瘤，但目前该方法越来越被认为是颅内动脉瘤的一线治疗方法。动脉瘤血管内治疗技术已有长足进步，新器材的研发使得以前因血管解剖结构复杂而无法填塞的动脉瘤也得以治疗，从而扩大了血管内治疗的适应证。而且，血管内弹簧圈栓塞已成为当前动脉瘤血管内治疗的主流方法；医学文献证明，在特定患者人群中，弹簧圈栓塞的转归优于外科手术夹闭。最近的一份美国心脏协会（AmericanHeartAssociation，AHA）科学声明指出，对于适合治疗的脑动脉瘤，不论是血管内栓塞还是显微外科手术夹闭，均为破裂动脉瘤I级推荐治疗方法和未破裂动脉瘤的11a级推荐治疗方法。在这两组患者中，治疗利大于弊。一个在血管显微神经外科、神经重症监护和介入神经外科方面有着丰富经验的多学科团队最有利于对颅内动脉瘤的处理实施最佳的技术。神经血管联合写作组此前已发表过一份联合声明，提出了有关脑血管介入治疗的培训和认证的推荐意见。

主 题 词：颅内动脉瘤栓塞治疗 未破裂动脉瘤 血管内弹簧圈栓塞 血管内治疗技术 美国食品药品监督管理局 外科手术夹闭 标准 脑动脉瘤 

学科分类：1002[医学-临床医学类] 100204[100204] 10[医学] 

D　O　I：10.3760/cma.j.issn.1673-4165.2013.06.002

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