Long-term outcomes of coil embolization of unruptured intracranial aneurysms
Long-term outcomes of coil embolization of unruptured intracranial aneurysms
复制标题
DOI：
10.3171/2017.6.jns17174
复制
发表时间：
2018-12-01
影响因子：
4.1
通讯作者：
Miyamoto, Susumu
中科院分区：
文献类型：
--
作者：
Koyanagi, Masaomi;Ishii, Akira;Miyamoto, Susumu
目的未破裂型颅内动脉瘤(UIA)经弹簧圈栓塞治疗后的远期疗效尚不清楚。这项研究的目的是分析在多个卒中中心随访长达20年的螺旋状UIA患者的破裂、再治疗、卒中和死亡的频率。方法作者回顾分析了1995-2004年间4个卒中中心接受螺旋栓塞术的患者的数据。在收集晚期(>；=1年)随访数据的过程中，邮寄问卷被用来评估患者是否经历过螺旋动脉瘤破裂或再次治疗或任何中风或死亡。中位随访期为12年(四分位数范围11-13年，最长20年)。对152例(81%)UIA进行了10年以上的随访。2122个动脉瘤年中发生破裂2个，年破裂发生率0.09%。188例盘绕性尿路感染患者中有9例(4.8%)接受了额外治疗。在这9例中，有5例在首次治疗后5年以上进行了第一次治疗。较大的动脉瘤更有可能需要再次治疗。在2122个动脉瘤形成的年份中发生了9次中风。17名患者在该队列中死亡。结论本研究显示盘状尿路内动脉破裂的风险较低，长期随访期长达20年。这表明，缠绕UIA可以在很长一段时间内防止破裂。然而，大型动脉瘤可能需要更长时间的随访。
OBJECTIVE Long-term follow-up results of the treatment of unruptured intracranial aneurysms (UIAs) by means of coil embolization remain unclear. The aim of this study was to analyze the frequency of rupture, retreatment, stroke, and death in patients with coiled UIAs who were followed for up to 20 years at multiple stroke centers.METHODS The authors retrospectively analyzed data from cases in which patients underwent coil embolization between 1995 and 2004 at 4 stroke centers. In collecting the late (>= 1 year) follow-up data, postal questionnaires were used to assess whether patients had experienced rupture or retreatment of a coiled aneurysm or any stroke or had died.RESULTS Overall, 184 patients with 188 UIAs were included. The median follow-up period was 12 years (interquartile range 11-13 years, maximum 20 years). A total of 152 UIAs (81%) were followed for more than 10 years. The incidence of rupture was 2 in 2122 aneurysm-years (annual rupture rate 0.09%). Nine of the 188 patients with coiled UIAs (4.8%) underwent additional treatment. In 5 of these 9 cases, the first retreatment was performed more than 5 years after the initial treatment. Large aneurysms were significantly more likely to require retreatment. Nine strokes occurred over the 2122 aneurysm-years. Seventeen patients died in this cohort.CONCLUSIONS This study demonstrates a low risk of rupture of coiled UIAs with long-term follow-up periods of up to 20 years. This suggests that coiling of UIAs could prevent rupture for a long period of time. However, large aneurysms might need to be followed for a longer time.