[1]柯勋昌,何旭英,李西锋,等.大型/巨大型颅内动脉瘤支架辅助与单纯弹簧圈栓塞术后复发率比较[J].介入放射学杂志,2017,(07):579-584.
 KE Xunchang,HE Xuying,LI Xifeng,et al.Stent- assisted coil embolization versus simple coil embolization for large and giant intracranial aneurysms: comparison of postoperative recurrence rate [J].journal interventional radiology,2017,(07):579-584.
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大型/巨大型颅内动脉瘤支架辅助与单纯弹簧圈栓塞术后复发率比较()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2017年07期
页码:
579-584
栏目:
神经介入
出版日期:
2017-07-25

文章信息/Info

Title:
Stent- assisted coil embolization versus simple coil embolization for large and giant intracranial aneurysms: comparison of postoperative recurrence rate 
作者:
柯勋昌 何旭英 李西锋 张 炘 方钦锐 李 维 王泽群 刘文超 段传志
Author(s):
KE Xunchang HE Xuying LI Xifeng ZHANG Xin FANG Qinrui LI Wei WANG Zequn LIU Wenchao DUAN Chuanzhi
Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, the Engineering Technology Research Center of Education Ministry of China, the National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangzhou, Guangdong Province 510282, China
关键词:
【关键词】 大型/巨大型动脉瘤 血管内栓塞 支架 复发 远期随访
文献标志码:
A
摘要:
【摘要】 目的 比较单纯弹簧圈栓塞和支架辅助弹簧圈栓塞颅内大型/巨大型动脉瘤的复发率及远期血管造影随访结果。方法 回顾性分析2004年1月至2016年1月收治的90例(91枚)大型或巨大型(>10 mm)颅内动脉瘤患者临床及影像资料,其中接受单纯弹簧圈栓塞治疗(NAC组)52例(52枚),支架辅助弹簧圈栓塞治疗(SAC组)38例(39枚),统计分析两组间术后动脉瘤复发率差异及复发危险因素。 结果 术后动脉瘤复发率、再治疗率分别为38.5%(35/91)、20.9%(19/91),其中SAC组分别为35.9%(14/39)与17.9%(7/39),NAC组分别为40.4%(21/52)与23.1%(12/52),但两组间差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,破裂动脉瘤(OR=0.284,95%CI=0.083~0.978,P=0.046)、单纯弹簧圈栓塞(OR=5.03,95%CI=1.04~24.44, P=0.045)、伴有高血压(OR=0.13,95%CI=0.036~0.51,P=0.003)及远期随访(OR=1.002,95%CI=1.001~1.003,P=0.002)是大型/巨大型动脉瘤复发的危险因素。结论 支架辅助弹簧圈栓塞可降低颅内大型/巨大型动脉瘤复发率,动脉瘤破裂、单纯弹簧圈栓塞、远期随访及伴发高血压是动脉瘤栓塞术后复发的独立危险因素。

参考文献/References:

[1] Gonzalez NR, Duckwiler G, Jahan R, et al. Challenges in the endovascular treatment of giant intracranial aneurysms[J]. Neuro- surgery, 2006, 59(5 Suppl 3): S113- S124.
[2] Wang B, Gao BL, Xu GP, et al. Endovascular embolization is applicable for large and giant intracranial aneurysms: experience in one center with long- term angiographic follow- up[J]. Acta Radiol, 2015, 56: 105- 113.
[3] Chalouhi N, Tjoumakaris S, Gonzalez LF, et al. Coiling of large and giant aneurysms: complications and long- term results of 334 cases[J]. AJNR Am J Neuroradiol, 2014, 35: 546- 552.
[4] Murayama Y, Nien YL, Duckwiler G, et al. Guglielmi detachable coil embolization of cerebral aneurysms: 11 years’ experience[J]. J Neurosurg, 2003, 98: 959- 966.
[5] Crobeddu E, Lanzino G, Kallmes DF, et al. Review of 2 decades of aneurysm- recurrence literature, part 1: reducing recurrence after endovascular coiling[J]. AJNR Am J Neuroradiol, 2013, 34: 266- 270.
[6] Hwang G, Park H, Bang JS, et al. Comparison of 2- year angio- graphic outcomes of stent- and nonstent- assisted coil embolization in unruptured aneurysms with an unfavorable configuration for coiling[J]. AJNR Am J Neuroradiol, 2011, 32: 1707- 1710.
[7] Ozretic D, Rados M, Pavlisa G, et al. Long- term angiographic outcome of stent- assisted coiling compared to non- assisted coiling of intracranial saccular aneurysms[J]. Croat Med J, 2015, 56: 24- 31.
[8] Canton G, Levy DI, Lasheras JC. Hemodynamic changes due to stent placement in bifurcating intracranial aneurysms[J]. J Neuro- surg, 2005, 103: 146- 155.
[9] Wanke I, Forsting M. Stents for intracranial wide- necked aneurysms: more than mechanical protection[J]. Neuroradiology, 2008, 50: 991- 998.
[10] 巴华君, 蔡建勇, 陆 川, 等. 支架辅助下弹簧圈栓塞颅内宽颈动脉瘤长期随访分析[J]. 介入放射学杂志, 2015, 24: 5- 9.
[11] Hong Y, Wang YJ, Deng Z, et al. Stent- assisted coiling versus coiling in treatment of intracranial aneurysm: a systematic review and meta- analysis[J]. PLoS One, 2014, 9: e82311.
[12] 伍强军, 杨鹏飞, 黄清海, 等. 颅内动脉瘤介入治疗后复发的危险因素分析及诊治进展[J]. 中国卒中杂志, 2013, 8: 899- 903.
[13] Nguyen TN, Hoh BL, Amin- Hanjani S, et al. Comparison of ruptured vs unruptured aneurysms in recanalization after coil embolization[J]. Surg Neurol, 2007, 68: 19- 23.
[14] Raymond J, Guilbert F, Weill A, et al. Long- term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils[J]. Stroke, 2003, 34: 1398- 1403.
[15] Piotin M, Blanc R, Spelle L, et al. Stent- assisted coiling of intracranial aneurysms: clinical and angiographic results in 216 consecutive aneurysms[J]. Stroke, 2010, 41: 110- 115.
[16] Piotin M, Pistocchi S, Bartolini B, et al. Intracranial aneurysm coiling with PGLA- coated coils versus bare platinum coils: long- term anatomic follow- up[J]. Neuroradiology, 2012, 54: 345- 348.
[17] Sluzewski M, van Rooij WJ. Early rebleeding after coiling of ruptured cerebral aneurysms: incidence, morbidity, and risk factors[J]. AJNR Am J Neuroradiol, 2005, 26: 1739- 1743.
[18] Boogaarts HD, van Lieshout JH, van Amerongen MJ, et al. Aneurysm diameter as a risk factor for pretreatment rebleeding: a meta- analysis[J]. J Neurosurg, 2015, 122: 921- 928.
[19] Machiel- Pleizier C, Algra A, Velthuis BK, et al. Relation between size of aneurysms and risk of rebleeding in patients with subarachnoid haemorrhage[J]. Acta Neurochir (Wien), 2006, 148: 1277- 1279.
[20] Guo LM, Zhou HY, Xu JW, et al. Risk factors related to aneurysmal rebleeding[J]. World Neurosurg, 2011, 76: 292- 298.
[21] Kim M, Taulbee DB, Tremmel M, et al. Comparison of two stents in modifying cerebral aneurysm hemodynamics[J]. Ann Biomed Eng, 2008, 36: 726- 741.
[22] Cho YD, Sohn CH, Kang HS, et al. Coil embolization of intracranial saccular aneurysms using the Low- profile Visualized Intraluminal Support (LVISTM) device[J]. Neuroradiology, 2014, 56: 543- 551.
[23] Ge H, Lü X, Yang X, et al. LVIS stent versus enterprise stent for the treatment of unruptured intracranial aneurysms[J]. World Neurosurg, 2016, 91: 365- 370.
[24] D’Urso PI, Lanzino G, Cloft HJ, et al. Flow diversion for intracranial aneurysms: a review[J]. Stroke, 2011, 42: 2363- 2368.
[25] Chalouhi N, Tjoumakaris S, Starke RM, et al. Comparison of flow diversion and coiling in large unruptured intracranial saccular aneurysms[J]. Stroke, 2013, 44: 2150- 2154.
[26] 陈 岩, 杨鹏飞, 周 宇, 等. 不同介入方法治疗颅内大型或巨大型动脉瘤的单中心经验[J]. 中国卒中杂志, 2013, 8: 868- 874.

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备注/Memo

备注/Memo:
(收稿日期:2016-11-23)
(本文编辑:边 佶)
更新日期/Last Update: 2017-07-12