Intraoperative Aneurysm Rupture Of Intracranial Aneurysms Interventional Treatment Processing Method

Objective:In the process of the surgical treatment of intracranial aneurysms,ruptured aneurysm of is very dangerous, that is the most serious complications, high morbidity and mortality, heavy damage to the patients’ families. Endovascular treatment of intracranial aneurysms started later than the skull clamps shuts,but the effect is satisfactory, multiple aneurysms, unruptured aneurysms or merger of vascular malformation such as aneurysm more has more advantages. This article through to the interventional treatment of ruptured intracranial aneurysm of the experience, focus on intravascular interventional treatment of intracranial aneurysm rupture risk factors, mechanism, prevention and treatment, provide help for clinical treatment.Methods:On July2009to March2014in the first affiliated hospital of Dalian medical university hospital neurosurgery of interventional treatment for patients with retrospective analysis, including9cases of patients with intracranial aneurysm rupture occurred,4cases were male, female in5cases, age47-68, with an average age of58.4years, Hent-Hess class Ⅰ-Ⅳ. Aneurysms are single, among them anterior communicating aneurysms in3patients,2cases of middle cerebral artery aneurysm, posterior communicating aneurysms3cases(1of whom underwent stent system auxiliary spring coil embolization),1case of the top of the basal artery aneurysm. Preoperative routine application of phenobarbital, atropine as preoperative medication, intraoperative adopt intravenous anesthesia, endotracheal intubation assisted ventilation. Preoperative patients were outfit CT diagnosis of subarachnoid hemorrhage, all dress CTA and DSA examination clear diagnosis of aneurysm. The patients were in the3days adept endovascular interventional treatment. All patients under general anesthesia via femoral artery using Seldinger technique short puncture in6F arterial sheath, under whole body heparinization, are performed by neurosurgeons (associate professor or above) by conventional intervention operation.Results:Intracranial aneurysm rupture of intracranial aneurysms interventional treatment of9cases of patients,1case occurred again after success in supporting system in the process of filling the spring coil,2cases occurred in the process of conveying micro gadget,3cases occurred after placing the catheter,3cases occurred in the process of filling spring coil.6cases of postoperative patients in our department intensive care unit(ICU),4patients were fully recovered,1case of patients with left speech disorders (postoperative3months after the review, patients can simple verbal communication with the family),1case of left side limb hemiplegic patients (review after3months, patients that can walk with the help of instrument), three of the ICU patients were transferred to the emergency department, line of breathing machine auxiliary ventilation treatment,1case of patients family members to give up treatment,1case died that night after respiratory cardiac arrest patients,1case died of respiratory failure on the third day after surgery.Conclusion:Interventional treatment of intracranial aneurysms in patients with rupture of high morbidity and mortality,the most common reason of the intraoperative aneurysm rupture is thread, micro catheter, spring coil prick aneurysm,timely and correctly deal with Intraoperative rupture of intracranial aneurysms rupture(IAR), neurosurgeons need to develop the cause of intracranial aneurysms, preoperative patients, fracture reasons, treatment, prevention, and other related issues, and make the most appropriate treatment measures. After the intracranial aneurysm rupture, neurosurgeons need to properly handle relevant issues, at the same time, the treatment is the key to the patients recovered after surgery.