Preliminary observation on predicting the need for coil extraction during microsurgery: the clip-coil ratio
Preliminary observation on predicting the need for coil extraction during microsurgery: the clip-coil ratio
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DOI：
10.1007/s00701-009-0559-z
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发表时间：
2010-03-01
影响因子：
2.4
通讯作者：
Carpenter, Jeffrey
中科院分区：
文献类型：
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作者：
Bulsara, Ketan R.;Hoh, Brian;Carpenter, Jeffrey
再通颅内动脉瘤显微手术期间弹簧圈取出可能与高发病率相关。我们评价了我们使用夹-弹簧圈比率预测弹簧圈取出需求的初步经验。对2005年至2009年期间因复发而夹闭的既往弹簧圈栓塞动脉瘤进行了多机构回顾性审查。测量再通的最大高度和宽度。其中最大的一个维度被另一个维度所分割。我们将其定义为夹式弹簧圈比，这是对纵横比的修改。患者的平均年龄为53岁（范围41-68岁）。动脉瘤位置为前交通动脉（n = 5）、胼胝体周围动脉（n = 2）、眼动脉（n = 1）和后交通动脉（n = 5）。夹-弹簧圈比率为1.3/1000日元，允许在不取出弹簧圈的情况下进行显微外科夹闭。这些患者的平均比值为1.6。在回顾我们的初步经验时，我们观察到当弹簧夹-弹簧圈比率为千分之一日元1.3时，在显微外科手术中不需要取出弹簧圈。该比值可作为可纳入夹内的动脉瘤组织量的间接指标;然而，鉴于患者人群较小，需要进一步研究来验证这一概念。
Coil extraction during microsurgery for recanalized intracranial aneurysms can be associated with high morbidity. We evaluated our preliminary experience using the clip-coil ratio to predict the need for coil extraction.A multi-institutional retrospective review of previously coiled aneurysms that were clipped for recurrence between 2005 and 2009 was performed. The maximal height and the widths of the recanalization were measured. The largest of these dimensions was divided by the other. We defined this as the clip-coil ratio, which is a modification of the aspect ratio.Thirteen patients were included in this study. The mean age of the patients was 53 years (range 41-68 years). The aneurysm locations were anterior communicating artery (n = 5), pericallosal artery (n = 2), ophthalmic artery (n = 1), and posterior communicating artery (n = 5). A clip-coil ratio a parts per thousand yen1.3 allowed for microsurgical clipping without coil extraction. The mean ratio in these patients was 1.6. Coil extraction was necessary in two patients with a clip-coil ratio < 1.3.In reviewing our preliminary experience, we observed that coil extraction during microsurgery was not necessary when the clip coil ratio was a parts per thousand yen1.3. The ratio may serve as an indirect indicator of the amount of aneurysm tissue that can be incorporated within a clip; however, given the small patient population, further studies are needed to validate this concept.