Điều trị phình động mạch não vỡ sau chấn thương bằng can thiệp nội mạch tại Bệnh viện Chợ Rẫy

Endovascular treatment of reptured traumatic cerebral aneurysm after brain injury in choray hospital

SUMMARY

Background: Traumatic intracranial aneurysms are rare, comprising 1% or less of all cerebral aneurysms. They can occur after even mild or severe head trauma, and are associated with significant morbidity and a mortality rate as high as 50%. Causes of pathogenesis, pathology and treatment methods differ from other cerebral aneurysms. So, the purpose of endovascular treatment is to prevent rebleeding and progressive cerebral dissecting anurysms.

Materials and methods: Endovascular treatment of ruptured traumatic cerebral artery aneurysms performed at Department of Radiology, Choray Hospital, from 01/2017 to 05/2018, the technique as follows: digital subtraction angiography, inserting of microcatheter over the aneurysm neck and other microcatheter insert to aneurysm, deploying stent over the aneurysm neck and coiling into aneurysm. The efficacy and safety were evaluated by variants: complete and partial occlusion rates, procedural success rate, clinical improvement, procedural complication.

Results: 33 cases of ruptured traumatic cerebral aneurysms treated by endovascular treatment, technical success rate 31/33 (93.9%) with stent assisted coiling (72.7%), parent artery occlusion (15.2%) and alone coiling (6.1%). Good outcome m-RS (0-2) were 25/33 cases (75.7%) , 5/33 cases (15.2%) reruptered and progressive cerebral dissecting anurysm cause mortality rates 3 cases (9.1%), morbidity rate (15.2%).

Conclusion: Endovascular treatment of ruptured traumatic cerebral aneurysms after brain injury were high safety and efficiency, improve good outcomes, low mortality complication rates.

Key words: Traumatic cerebral aneurysms, Stent assisted coiling, endovascular treatment.