脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
特集 未破裂脳動脈瘤のコイル塞栓術
ダブルマイクロカテーテル法を使用した未破裂脳動脈瘤に対する瘤内コイル塞栓術の治療成績
毛利 正直内山 尚之渡邉 卓也見崎 孝一林 康彦林 裕濱田 潤一郎
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2011 年 39 巻 6 号 p. 393-397

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We evaluated the radiologic and clinical outcome of unruptured intracranial aneurysms treatment by using double microcatheters into the aneurysm. Between October 2006 and December 2009, 30 patients with 30 aneurysms were treated, including 12 patients treated by using double microcatheters and 18 patients treated by using a single microcatheter. The volume embolization ratio (VER) ―percentage of the coil volume occupying the aneurysmal lumen―was used as an index to evaluate the radiologic results. The VER of aneurysms treated with double-microcatheter technique was 25.2±4.8%, and the VER of aneurysms treated with the single-microcatheter technique was 21.6±3.9% (P<0.05). There was 1 ischemic complication in the single-microcatheter technique group, and no complications in the double-microcatheter technique group.
Although in the aneurysms with a long aneurysmal diameter/short aneurysmal diameter (L/S) ratio less than 1.5, there were no significant differences between the 2 groups, in the aneurysms with a L/S ratio of 1.5 or greater, the VER of aneurysms treated with the double-microcatheter technique was 27.6±4.3%, and the VER of aneurysms treated with single-catheter technique was 19.7±3.4% (P<0.05). The advantage of the double-microcatheter technique is that placing 2 microcatheters into the aneurysm allowed 2 coils to achieve a stable coil configuration before either coil was detached.
The double microcatheter technique is an effective and safe treatment for unruptured aneurysms.
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© 2011 一般社団法人 日本脳卒中の外科学会
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