[1]姚永治,权 涛,管 生,等.颅内动脉瘤介入栓塞术后微栓子信号监测 [J].介入放射学杂志,2018,27(04):299-302.
 YAO Yongzhi,QUAN Tao,GUAN Sheng,et al.Microembolic signal monitoring after interventional embolization therapy for intracranial aneurysms[J].journal interventional radiology,2018,27(04):299-302.
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年04期
页码:
299-302
栏目:
神经介入
出版日期:
2018-04-25

文章信息/Info

Title:
Microembolic signal monitoring after interventional embolization therapy for intracranial aneurysms
作者:
姚永治 权 涛 管 生 刘 朝 李冬冬 陈 振 徐浩文
Author(s):
YAO Yongzhi QUAN Tao GUAN Sheng LIU Chao LI Dongdong CHEN Zhen XU Haowen
Department of Neurointervention, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450052, China
关键词:
【关键词】 微栓子信号 经颅多普勒 弥散加权成像 缺血并发症 颅内动脉瘤
文献标志码:
A
摘要:
【摘要】 目的 探讨颅内动脉瘤介入栓塞术后微栓子产生机制及其对预后的影响。方法 前瞻性研究颈内动脉颅内段动脉瘤介入栓塞术患者,术后即刻采用经颅多普勒(TCD)仪监测微栓子30 min,术后3 d作头颅MR弥散加权成像(DWI)检查,分析术后微栓子产生机制及其对预后的影响。结果 2016年1月至2017年8月共有140例颈内动脉动脉瘤患者接受TCD监测。术后微栓子信号(MES)、DWI梗死灶阳性率分别为17.1%(24/140)、68.6%(96/140),24例MES阳性患者DWI梗死灶均阳性。13例(9.3%)DWI阳性患者出现围手术期缺血并发症,症状较轻(术后1周改良Rankin量表评分均≤2分),其中MES阳性9例。支架辅助栓塞患者MES阳性率显著高于单纯弹簧圈栓塞患者(25.8%对2.0%,χ2=13.491,P<0.000 1)。缺血并发症与MES阳性、DWI梗死灶阳性均有相关性(Kendall相关系数分别为0.404、0.217,P<0.000 1、P=0.011),MES阳性与DWI梗死灶阳性也呈相关性(Pearson相关系数0.470,P<0.001)。结论 支架辅助栓塞是颅内动脉瘤栓塞术后产生微栓子的主要危险因素。TCD微栓子监测可作为预测颅内动脉瘤栓塞术后缺血并发症的非侵入性、便捷、有效方法。

参考文献/References:

[1] 张彦冰, 管 生, 郭新宾, 等. 颅内动脉瘤介入治疗围术期缺血并发症病因分析与防治(附48例报告)[J]. 介入放射学杂志, 2017, 26: 291- 295.
[2] Spelle L, Pierot L. Endovascular treatment of non- ruptured intracranial aneurysms: critical analysis of the literature[J]. J Neuroradiol, 2008, 35: 116- 120.
[3] Schubert GA, Thome C, Seiz M, et al. Microembolic signal monitoring after coiling of unruptured cerebral aneurysms: an observational analysis of 123 cases[J]. AJNR Am J Neuroradiol, 2010, 32: 1386- 1391.
[4] Jo K, Yeon JY, Kim KH, et al. Predictors of thromboembolism during coil embolization in patients with unruptured intracranial aneurysm[J]. Acta Neurochir(Wien), 2013, 155: 1101- 1106.
[5] King A, Markus HS. Doppler embolic signals in cerebrovascular disease and prediction of stroke risk: a systematic review and meta- analysis[J]. Stroke, 2009, 40: 3711- 3717.
[6] Markus HS, King A, Shipley M, et al. Asymptomatic embolisation for prediction of stroke in the Asymptomatic Carotid Emboli Study(ACES): a prospective observational study[J]. Lancet Neurol, 2010, 9: 663- 671.
[7] 梁晓东, 王子亮, 李天晓, 等. 替罗非班在颅内破裂动脉瘤介入治疗术中预防性应用研究[J]. 介入放射学杂志, 2015, 24: 1034- 1038.
[8] Goertler M, Blaser T, Krueger S, et al. Cessation of embolic signals after antithrombotic prevention is related to reduced risk of recurrent arterioembolic transient ischaemic attack and stroke[J]. J Neurol Neurosurg Psychiatry, 2002, 72: 338- 342.
[9] Klotzsch C, Nahser HC, Henkes H, et al. Detection of microemboli distal to cerebral aneurysms before and after therapeutic embolization[J]. AJNR Am J Neuroradiol, 1998, 19: 1315- 1318.
[10] Cho JH, Kang DH, Kim YW, et al. Microembolic signal monitoring and the predictionof thromboembolic events following coil embolization of unruptured intracranial aneurysms: diffusion- weighted imaging correlation[J]. Neuroradiology, 2015, 57: 189- 196.
[11] Schubert GA, Thome C, Seiz M, et al. Microembolic signal monitoring after coiling of unruptured cerebral aneurysms: an observational analysis of 123 cases[J]. AJNR Am J Neuroradiol, 2011, 32: 1386- 1391.
[12] Soeda A, Sakai N, Sakai H, et al. Thromboembolic events associated with Guglielmi detachable coil embolization of asymptomatic cerebral aneurysms: evaluation of 66 consecutive cases with use of diffusion- weighted MR imaging[J]. AJNR Am J Neuroradiol, 2003, 24: 127- 132.
[13] 陈 振, 刘 朝, 李冬冬, 等. LVIS支架辅助栓塞颅内动脉瘤安全性及有效性分析[J]. 介入放射学杂志, 2017, 26: 775- 778.
[14] Kang DH, Kim BM, Kim DJ, et al. MR- DWI- positive lesions and symptomatic ischemic complications after coiling of unruptured intracranial aneurysms[J]. Stroke, 2013, 44: 789- 791.

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备注/Memo

备注/Memo:
(收稿日期:2017-10-27)
(本文编辑:边 佶)
更新日期/Last Update: 2018-04-16