Association between extracranial internal carotid artery tortuosity and thromboembolic complications during coil embolization of anterior circulation ruptured aneurysms
Association between extracranial internal carotid artery tortuosity and thromboembolic complications during coil embolization of anterior circulation ruptured aneurysms
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DOI：
10.1007/s00701-019-03903-7
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发表时间：
2019-04
影响因子：
2.4
通讯作者：
Atsushi Ogata;K. Suzuyama;Ryo Ebashi;Y. Takase;Kohei Inoue;J. Masuoka;Fumitaka Yoshioka;Y. Nakahara;T. Abe
中科院分区：
文献类型：
--
作者：
Atsushi Ogata;K. Suzuyama;Ryo Ebashi;Y. Takase;Kohei Inoue;J. Masuoka;Fumitaka Yoshioka;Y. Nakahara;T. Abe
背景：脑动脉瘤破裂线圈栓塞术中最常见的神经系统并发症是血栓栓塞事件。颅内动脉瘤栓塞术中颈动脉曲度（ICA）与血栓栓塞事件（tee）之间的关系尚不清楚。本研究旨在探讨前循环破裂动脉瘤线圈栓塞术中颅内外ICA扭曲与血栓栓塞并发症的关系。方法回顾性分析在同一医院行血管内栓塞术的57例前循环破裂动脉瘤患者。根据患者的基线特征、手术因素以及包括动脉瘤和颅外ICA扭曲在内的解剖学因素，将患者分为两组，分别为经历tee和未经历tee的两组。动脉瘤的解剖因素包括最大穹窿大小、颈宽、穹窿与颈比、穹窿与颈宽比。颅外近端和远端曲度的ICA角被评估为ICA扭曲。结果57例患者中有3例因缺乏ICA扭曲的资料而被排除；最终对54例患者进行评估。6例患者有5例脑前动脉瘤和1例颈内动脉瘤。tee患者的颅外远端ICA角明显大于无tee患者。手术因素和解剖因素与tee无关。结论颅内ICA曲度与前循环破裂动脉瘤血管内盘绕术中血栓栓塞事件的发生率显著相关。
BackgroundThe most frequent neurological complication during coil embolization of a ruptured cerebral aneurysm is a thromboembolic event. The association between the tortuosity of the internal carotid artery (ICA) and thromboembolic events (TEEs) during coil embolization of ruptured cerebral aneurysms remains unclear. The present study aimed to investigate the association between extracranial ICA tortuosity and thromboembolic complications during coil embolization of anterior circulation ruptured aneurysms.MethodsA cohort of 57 patients with 57 anterior circulation ruptured aneurysms who underwent endovascular embolization at a single institution was retrospectively investigated. Patients were divided into two groups, those who experienced TEEs and those who did not that were compared and analyzed based on patient baseline characteristics, procedural factors, and anatomical factors including those of aneurysms and extracranial ICA tortuosity. The anatomical factors of the aneurysms included maximum dome size, neck width, dome-to-neck ratio, and dome-to-neck aspect ratio. Extracranial ICA angles in the proximal and distal curvature were evaluated as ICA tortuosity.ResultsThree of the 57 patients were excluded because of unavailability of data regarding ICA tortuosity; 54 patients were finally evaluated. TEEs occurred in six patients with five anterior cerebral and one internal carotid aneurysms. The extracranial distal ICA angle was significantly larger in patients with TEEs than in those without. Procedural factors and anatomical factors of the aneurysms were not associated with TEEs.ConclusionsExtracranial ICA tortuosity was significantly associated with an increased incidence of thromboembolic events during endovascular coiling of anterior circulation ruptured aneurysms.