EMBOLIZATION OF INTRACRANIAL ANEURYSMS WITH HYDROGEL‐COATED COILS: RESULT OF A KOREAN MULTICENTER TRIAL
EMBOLIZATION OF INTRACRANIAL ANEURYSMS WITH HYDROGEL‐COATED COILS: RESULT OF A KOREAN MULTICENTER TRIAL
复制标题
水凝胶涂层弹簧圈栓塞颅内动脉瘤：韩国多中心试验的结果
DOI：
10.1227/01.neu.0000279723.67779.f0
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发表时间：
2007
期刊：
影响因子：
4.8
通讯作者：
H. Byun
中科院分区：
文献类型：
--
作者：
Hyun;M. Han;T. Lee;Y. Shin;H. Roh;O. Kwon;B. Kwon;S. Y. Kim;Sung Hyun Kim;H. Byun
目的 HydroCoil（MicroVention，加利福尼亚州亚里索维耶霍）是一种水凝胶-铂弹簧圈混合装置，是克服盘绕颅内动脉瘤延迟再通的各种努力之一。本研究的目的是调查 HydroCoils 治疗颅内动脉瘤的结果。方法 这项多中心前瞻性研究包括 76 名接受 HydroCoils 治疗的患者的 80 个动脉瘤。 32 个（40%）动脉瘤破裂，48 个（60%）未破裂； 22 例（28%）为大动脉瘤（最大直径≥10 毫米），58 例（72%）为小动脉瘤。 48 例 (60%) 的动脉瘤体积为 100 mm3 或以上，32 例 (40%) 的动脉瘤体积小于 100 mm3； 13 个动脉瘤 (16%) 的体积为 600 mm3 或更大。根据初始闭塞程度、手术相关并发症和随访结果评估疗效和安全性。结果 60 个动脉瘤 (75%) 的初始动脉瘤闭塞是完全的，14 个动脉瘤 (17.5%) 的初始动脉瘤闭塞接近完全。手术相关并发症包括无菌性脑膜炎相关问题，包括 13 名患者出现迟发性脑积水（未破裂动脉瘤病例中占 28%）和 2 名患者出现血栓栓塞。 54 个动脉瘤（68%）在弹簧圈栓塞后 6 个月或更长时间获得的放射学随访数据显示，48 个（89%）动脉瘤稳定闭塞，1 个（2%）动脉瘤出现轻微再通，5 个（9%）动脉瘤出现大再通。所有再通的动脉瘤体积均在600 mm3或以上，在多元Logistic回归分析中，动脉瘤体积是与延迟再通相关的一个重要变量（P = 0.016）。结论 就初始动脉瘤闭塞率和随访评估时的耐久性而言，HydroCoil 栓塞似乎是颅内动脉瘤的一种可行的治疗选择；然而，需要谨慎对待无菌性脑膜炎和迟发性脑积水。计算出的 600 mm3 动脉瘤体积似乎对于确定 HydroCoils 栓塞动脉瘤的解剖结果至关重要。
OBJECTIVE HydroCoil (MicroVention, Aliso Viejo, CA), a hydrogel-platinum coil hybrid device, is one of various efforts to overcome delayed recanalization of coiled intracranial aneurysms. The purpose of this study was to investigate the outcome of intracranial aneurysms treated with HydroCoils. METHODS This multicenter prospective study included 80 aneurysms in 76 patients treated with HydroCoils. There were 32 (40%) ruptured and 48 (60%) unruptured aneurysms; 22 (28%) were large aneurysms (maximal diameter, ≥10 mm) and 58 (72%) were small. Aneurysm volumes were 100 mm3 or more in 48 (60%) and less than 100 mm3 in 32 (40%); in 13 aneurysms (16%), volumes were 600 mm3 or more. Efficacy and safety were evaluated on the basis of degree of initial occlusion, procedure-related complications, and the follow-up result. RESULTS Initial aneurysmal occlusion was complete in 60 (75%) aneurysms and near-complete in 14 (17.5%). Procedure-related complications included aseptic meningitis-related problems, including delayed hydrocephalus in 13 patients (28% among cases of unruptured aneurysms) and thromboembolism in two patients. Radiological follow-up data obtained 6 months or more after coil embolization were available in 54 aneurysms (68%) and revealed stable occlusion in 48 (89%) aneurysms, minor recanalization in one (2%), and major recanalization in five (9%). All of the recanalized aneurysms were 600 mm3 or more in volume, and aneurysm volume was a single important variable related to delayed recanalization on multiple logistic regression analysis (P = 0.016). CONCLUSION HydroCoil embolization seems to be a feasible treatment option in intracranial aneurysms in terms of initial aneurysmal occlusion rate and durability at the time of the follow-up evaluation; however, caution is required regarding aseptic meningitis and delayed hydrocephalus. Calculated aneurysmal volume of 600 mm3 seems to be critical in determining the anatomic outcome in aneurysms embolized with HydroCoils.
影响因子：
4.1
作者：
GUGLIELMI, G;VINUELA, F;SEPETKA, I
通讯作者：
SEPETKA, I