课件：颅内动脉瘤的介入治疗.ppt

* * * IMAGE GUIDEDTHERAPIESMedia Briefing S p o n s o r e d b y t h e Radiological Societyof North America Brain Aneurysms Successfully Treated Without Open Surgery V A S C U L A R D I S E A S E Jacques E. Dion, M.D. Emory University Hospital S p o n s o r e d b y t h e Radiological Society of North America Brain Aneurysms Successfully Treated Without Open Surgery Jacques E. Dion, M.D., FRCP (C) Professor of Radiology Neurosurgery Director, Interventional Neuroradiology Emory University Hospital Atlanta, GA History of Coiling 1987-1989: Dr Guido Guglielmi (University of Rome) visits Dr Vi?uela (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 The Lancet Vol 360, October 26, 2002 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 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 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