Avtor/Urednik		Šeruga, Tomaž
Naslov		Zdravljenje anevrizem možganskih arterij z embolizacijo
Tip		članek
Vir		Bilt DRI
Vol. in št.		Letnik 19, št. 2
Leto izdaje		2002
Obseg		str. 30-9
Jezik		slo
Abstrakt		Starting poits: A presentation of endovascular intervention treatment of brain arteries aneurysms by embolization carried out with the Guglielmi platinum coils system (GDC). Methods: Endovascular treatment was applied in three patients having intracranial aneurysms. In two patients aneurysms were ruptured and the patients suffered a massive subarachnoidal bleeding, while the aneurysm in the third (female) patient was discovered incidentally. The aneurysm was obliterated with the platinum loops separated from the metal support with electrolysis by means of a Tracker-10 micro-catheter. The system of detachable coils has been named after its inventor Guglielmi (GDC). Results: Control angiographies after the aneurysm embolization showed the correct position of coils in the aneurysms, which were excluded from the circulation. The distal parts of arteries were entirely preserved. The survival of patients depends primarily on their clinical status before the procedure. The (female) patient with the aneurysm that had not ruptured was discharged the following day and was well, the two patients with massive subarachnoidal bleeding, who were not in a condition to undergo an operation, died after two weeks because of the primary bleeding. Conclusions: Intervention treatment of brain arteries aneurysm by embolization is an additional method in the already established surgical therapy. In patients who cannot undergo an operation it is the only possible way of protection against another fatal bleeding. This intervention is non-invasive and does not cause any additional damage to the already affected brain. The method has been clinically applied for about a decade, so the researches as far as permanent results are concerned are not final yet.
Izvleček		Izhodišča: Prikaz intervencijskega endovaskularnega zdravljenja anevrizem možganskih arterij z embolizacijo s pomočjo Guglielmijevega sistema platinastih zank (GDC). Metode: Endovaskularni postopek zdravljenja smo uporabili pri treh bolnikih s tremi intrakranialnimi anevrizmami. Dve anevrizmi sta bili rupturirani in bolnika sta utrpela obsežno subarahnoidno krvavitev, pri tretji bolnici je bila anevrizma odkrita naključno. S pomočjo Tracker-10 mikrokatetra, smo anevrizmo embolizirali s platinastimi zankami, ki jih od kovinskega vodila ločimo z elektrolizo. Sistem snemnih zank se imenuje po izumitefju Guglielmi detachable coil (GDC). Rezultati: Kontrolne angiografije po embolizaciji anevrizem so pokazale pravilen položaj zank v anevrizmah, ki so bile izključene iz cirkulacije. Distalni deli arterij so bili v celoti ohranjeni. Preživetje bolnikov je odvisno predvsem od kliničnega stanja bolnikov pred posegom. Bolnica z nerupturirano anevrizmo je zapustila bolnico naslednji dan zdrava, bolnika s težko subarahnoidno krvavitvijo, ki za kirurški poseg nista bila več sposobna, sta po dveh tednih umrla za posledicami prvotne krvavitve. Zaključki: Intervencijsko zdravljenje anevrizem možganskega ožilja z embolizacijo, predstavlja dopolnilni način uveljavljeni kirurški terapiji. Pri bolnikih, ki niso sposobni za operacijo, predstavlja edini mogoči način zaščite pred usodno ponovno krvavitvijo. Poseg je neinvaziven in pri že prizadetih možganih ne povzroča dodatnih poškodb. Metoda se klinično uporablja slabo desetletje, zato raziskave na področju trajnosti rezultatov še niso dokončne.
Deskriptorji		ANEURYSM, RUPTURED CEREBRAL ARTERY DISEASES EMBOLIZATION, THERAPEUTIC SUBARACHNOID HEMORRHAGE