颅内动脉瘤的介入治疗-英文课件

Aneurysm Facts

Symptoms of ruptured aneurysms:


The worst headache of your life
Localized and intense headache Nausea and vomiting Stiff neck or neck pain Blurred or double vision Pain above and behind eye Dilated pupils Sensitivity to light Loss of sensation




1987-1989: Dr Guido Guglielmi (University of Rome) visits Dr Viñuela (Interventional Neuroradiologist) at UCLA and research work on coiling concept starts 1989: Dr Guglielmi comes permanently to UCLA 1989-1990: Bench and animal research March 6, 1990: First clinical use of Guglielmi Detachable Coil

FDA approval in 1995
International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized trial
Jacques E. Dion, M.D., FRCP (C)
Professor of Radiology & Neurosurgery Director, Interventional Neuroradiology Emory University Hospital Atlanta, GA
History of Coiling
IMAGE GUIDED THERAPIES
Media Briefing
VASCULAR DISEASE
Brain Aneurysms Successfully Treated Without Open Surgery
Brain Aneurysms Successfully Treated Without Open Surgery


Aneurysm Therapy

Surgical clipping (approximately 60-65% in the United States)
Aneurysm Demographics





Aneurysms are found in 2-5% of the population There are as many as 27,000 aneurysms that could be diagnosed and treated per year in the U.S. They are more common in women (Sharon Stone had an aneurysm that was treated with coils by an interventional neuroradiologist) The annual rupture rate is approximately 1.5% Rupture of an aneurysm results in approximately 50% mortality and 25% stroke incidence
What Is An Aneurysm?
A cerebral aneurysm is a bubble like outpouching from an artery which predisposes its carrier to cerebral hemorrhage and stroke
Images © Frank H. Netter, CIBA Collection of Medical Illustrations
The Lancet
ISAT

A recent large prospective study of 2143 patients with ruptured aneurysms who could equally be treated with clipping or coiling had to be prematurely stopped short of planned enrollment of 2500 patients because the coiled patients suffered significantly less death and dependency as compared to clipped patients (6.9% absolute difference, 22.6% relative difference) and it would have been unethical to continue the study
Aneurysm Facts

Factors believed to contribute to brain aneurysms:
Βιβλιοθήκη Baidu
Smoking Hypertension Traumatic head injury Alcohol use Use of oral contraception Family history of brain aneurysms Other inherited disorders: Ehler’s syndrome, polycystic kidney disease, and Marfan syndrome