[1]顾斌贤,李明华,王 武,等. 单个弹簧圈栓塞颅内微小动脉瘤的单中心经验[J].介入放射学杂志,2012,(01):7-13.
 GU Bin xian,LI Ming hua,WANG Wu,et al.Endovascular embolization with a single detachable coil for tiny intracranial aneurysms: a single-center experience[J].journal interventional radiology,2012,(01):7-13.
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 单个弹簧圈栓塞颅内微小动脉瘤的单中心经验 ()

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

卷:
期数:
2012年01期
页码:
7-13
栏目:
神经介入
出版日期:
2012-01-30

文章信息/Info

Title:
Endovascular embolization with a single detachable coil for tiny intracranial aneurysms: a single-center experience
作者:
 顾斌贤李明华王 武施万印
200233 上海交通大学附属第六人民医院介入影像科
Author(s):
GU Bin xian LI Ming hua WANG Wu SHI Wan yin.
Department of Diagnostic and Interventional Neuroradiology, the Affiliated Sixth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200233, China
关键词:
 【关键词】颅内微小动脉瘤血管内治疗弹簧圈支架球囊
文献标志码:
A
摘要:
【摘要】 目的 探讨单个弹簧圈栓塞颅内微小动脉瘤(最大径< 3 mm)的可行性和疗效。方法 2001年1月至2011年1月对72例颅内微小动脉瘤患者的77个动脉瘤进行单个弹簧圈栓塞,其中动脉瘤破裂出血52例,多发性动脉瘤13例。用3DDSA选择工作角度测量动脉瘤大小(前后径、上下径、宽颈、最大径和瘤颈)。随访脑血管造影3 ~ 88个月(平均24.8个月)。结果 对所有77个微小动脉瘤成功实施了单个弹簧圈栓塞,其中10个采用球囊辅助弹簧圈栓塞,19个联合支架辅助弹簧圈栓塞。术中破裂出血7例,发生脑栓塞事件2例,术中弹簧圈移位2例。术后即刻造影示完全栓塞42个,次全栓塞30个,部分栓塞5个。除2例死亡外,所有病例进行了至少2次复查(术后3和12个月),其中再通5个,对3个进行了再次栓塞,延迟性弹簧圈移位2例。12个月后复查造影示完全栓塞61个,次全栓塞14个。结论 单个弹簧圈栓塞颅内微小动脉瘤可行、安全并有效,联合支架辅助治疗可以降低其再通率。

参考文献/References:

[1] Goddard JK, Moran CJ, Cross DT 3rd, et al. Absent relationship between the coil-embolization ratio in small aneurysms treated with a single detachable coil and outcomes[J]. AJNR, 2005, 26: 1916 - 1920.
[2] Kwon HJ, Park JB, Kwon Y, et al. Long-term clinical and radiologic results of small cerebral aneurysms embolized with 1 or 2 detachable coils[J]. Surg Neurol, 2006, 66: 507 - 512.
[3] Suzuki S, Kurata A, Ohmomo T, et al. Endovascular surgery for very small ruptured intracranial aneurysms. Technical note[J]. J Neurosurg, 2006, 105: 777 - 780.
[4] Chen Z, Feng H, Tang W, et al. Endovascular treatment of very small intracranial aneurysms[J]. Surg Neurol, 2008, 70: 30 - 35.
[5] Gupta V, Chugh M, Jha AN, et al. Coil embolization of very small (2 mm or smaller) berry aneurysms: feasibility and technical issues[J]. AJNR, 2009, 30: 308 - 314.
[6] van Rooij WJ, Keeren GJ, Peluso JP, et al. Clinical and angiographic results of coiling of 196 very small (< or = 3 mm) intracranial aneurysms[J]. AJNR, 2009, 30: 835 - 839.
[7] Yang MS, Wong HF, Yang TH, et al. Alternative option in the treatment of very small ruptured intracranial aneurysms[J]. Surg Neurol, 2009, 72 Suppl 2: S41 - S46.
[8] Ioannidis I, Lalloo S, Corkill R, et al. Endovascular treatment of very small intracranial aneurysms[J]. J Neurosurg, 2010, 112: 551 - 556.
[9] Hwang JH, Roh HG, Chun YI, et al. Endovascular coil embolization of very small intracranial aneurysms[J]. Neuroradiology, 2011, 53: 349 - 357.
[10] Chae KS, Jeon P, Kim KH, et al. Endovascular coil embolization of very small intracranial aneurysms[J]. Korean J Radiol, 2010, 11: 536 - 541.
[11] Lu J, Liu JC, Wang LJ, et al. Tiny intracranial aneurysms: Endovascular treatment by coil embolisation or sole stent deployment[J]. Eur J Radiol, 2011: 005.
[12] Nguyen TN, Raymond J, Guilbert F, et al. Association of endovascular therapy of very small ruptured aneurysms with higher rates of procedure-related rupture[J]. J Neurosurg, 2008, 108: 1088 - 1092.
[13] Gil A, Vega P, Murias E, et al. Balloon-assisted extrasaccular coil embolization technique for the treatment of very small cerebral aneurysms[J]. J Neurosurg, 2010, 112: 585 - 588.
[14] Sluzewski M, van Rooij WJ, Slob MJ, et al. Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils[J]. Radiology, 2004, 231: 653 - 658.
[15] Kai Y, Hamada J, Morioka M, et al. Evaluation of the stability of small ruptured aneurysms with a small neck after embolization with Guglielmi detachable coils: correlation between coil packing ratio and coil compaction[J]. Neurosurgery, 2005, 56: 785 - 792.
[16] Pakbaz RS, Kerber CW. Complex curve microcatheters for berry aneurysm endovascular therapy[J]. AJNR, 2007, 28: 179-180.
[17] Toyota S, Fujimoto Y, Iwamoto F, et al. Technique for shaping microcatheter tips in coil embolization of paraclinoid aneurysms using full-scale volume rendering images of 3D rotational angiography[J]. Minim Invasive Neurosurg, 2009, 52: 201 - 203.
[18] Li MH, Gao BL, Fang C, et al. Angiographic follow-up of cerebral aneurysms treated with Guglielmi detachable coils: an analysis of 162 cases with 173 aneurysms[J]. AJNR, 2006, 27: 1107 - 1112.
[19] 王 武, 李明华, 杜倬婴, 等. Neuroform3支架在急诊血管内栓塞破裂性颅内宽颈动脉瘤中的应用[J]. 介入放射学杂志, 2009, 18: 4 - 10.
[20] 顾斌贤, 李明华, 王 武. 弹簧圈血管内栓塞颅内动脉瘤危急事件中支架的应用[J]. 介入放射学杂志, 2011, 20: 93 - 96.
[21] Henkes H, Reinartz J, Preiss H, et al. Endovascular treatment of small intracranial aneurysms: three alternatives to coil occlusion[J]. Minim Invasive Neurosurg, 2006, 49: 65 - 69.
[22] Molyneux AJ, Kerr RS, Yu LM, et al. International subarachnoid aneurysm trial(ISAT) of neurosurgical clipping versus endovas-cular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion[J]. Lancet, 2005, 366: 809 - 817.
[23] Wiebers DO, Whisnant JP, Huston J, et al. International study of unruptured intracranial aneurysms investigators.unruptured intracranial aneurysms:natural history,clinical outcome,and risks of surgical and endovascular treatment[J]. Lancet, 2003, 362: 103 - 110.
[24] Russell SM, Lin K, Hahn SA, et al. Smaller cerebral aneurysms producing more extensive subarachnoid hemorrhage following rupture: a radiological investigation and discussion of theoretical determinants[J]. J Neurosurg, 2003, 99: 248 - 253.
[25] Taylor CL, Steele D, Kopitnik TA Jr, et al. Outcome after subarachnoid hemorrhage from a very small aneurysm: a case-control series[J]. J Neurosurg, 2004, 100: 623 - 625.
[26] van Rooij WJ, Sprengers ME, de Gast AN, et al. 3D rotational angiography: the new Gold standard in the detection of additional intracranial aneurysms[J]. AJNR, 2008, 29: 976 - 979.
[27] Li MH, Cheng YS, Li YD, et al. Large-cohort comparison between three-dimensional time-of-flight magnetic resonance and rotational digital subtraction angiographies in intracranial aneurysm detection[J]. Stroke, 2009, 40: 3127 - 3129.
[28] Sluzewski M, Bosch JA, van Rooij WJ, et al. Rupture of intracranial aneurysms during treatment with Guglielmi detachable coils: incidence, outcome, and risk factors[J]. J Neurosurg, 2001, 94: 238 - 240.
[29] Gao BL, Li MH, Wang YL, et al. Delayed coil migration from a small wide-necked aneurysm after stent-assisted embolization: case report and literature review[J]. Neuroradiology, 2006, 48: 333 - 337.
[30] Brinjikji W, Lanzino G, Cloft HJ, et al. Endovascular treatment of very small (3 mm or smaller) intracranial aneurysms: report of a consecutive series and a meta-analysis[J]. Stroke, 2010, 41: 116 - 121.
[31] Pierot L, Spelle L, Vitry F. Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach: results of the ATENA study[J]. Stroke, 2008, 39: 2497 - 2504.
[32] Li MH, Gao BL, Fang C, et al. Prevention and management of intraprocedural rupture of intracranial aneurysm with detachable coils during embolization[J]. Neuroradiology, 2006, 48: 907 - 915.
[33] Lim YC, Kim BM, Shin YS, et al. Structural limitations of currently available microcatheters and coils for endovascular coiling of very small aneurysms[J]. Neuroradiology, 2008, 50: 423 - 427.

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备注/Memo

备注/Memo:
(收稿日期:2011-07-10)
更新日期/Last Update: