Endovascular Therapy for Asymptomatic Unruptured Intracranial Aneurysms JR-NET and JR-NET2 Findings
Endovascular Therapy for Asymptomatic Unruptured Intracranial Aneurysms JR-NET and JR-NET2 Findings
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DOI：
10.1161/strokeaha.111.000609
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发表时间：
2013-10-01
期刊：
影响因子：
8.3
通讯作者：
Sakai, Nobuyuki
中科院分区：
文献类型：
--
作者：
Shigematsu, Tomoyoshi;Fujinaka, Toshiyuki;Sakai, Nobuyuki
背景和目的国家注册研究（日本神经血管内治疗注册研究[JR-NET]和JR-NET 2）已经确定了神经血管内治疗（neuro-EVT）的现状和结局。我们分析了EVT治疗无症状未破裂颅内动脉瘤（UIAs. Methods）的短期结局，我们从JR-NET和JR-NET 2数据库中所有EVT的31 968例注册手术记录中提取了4767例无症状UIAs的EVT围手术期信息。我们评估了动脉瘤和程序的特点，即时影像学检查结果，程序相关的并发症，并在30天后的临床outcomes.Results我们位于前循环中的UIA的80.0%，最常见的是床突旁。2.5%、32.9%、51.9%、12.0%和0.7%的UIA的直径分别为20 mm。EVT失败率仅为2.1%。在54.8%的手术中应用了辅助技术。术前和术后抗血小板药物处方分别为85.6%和84.0%的程序。57.7%、31.9%和10.0%的UIA的即刻影像学结局分别包括完全闭塞、残留瘤颈和残留动脉瘤。并发症，与9.1%的程序，包括2.0%出血和4.6%缺血，30天的发病率和死亡率分别为2.12%和0.31%.Conclusions EVT无症状UIA在日本的影像学结果是可以接受的，死亡率和发病率低。
Background and Purpose National registration studies (the Japanese Registry of Neuroendovascular Therapy [JR-NET] and JR-NET2) have determined the current status and outcomes of neuroendovascular therapy (neuro-EVT). We analyzed short-term outcomes of EVT for asymptomatic unruptured intracranial aneurysms (UIAs).Methods We extracted periprocedural information about EVT for 4767 asymptomatic UIAs from 31 968 registered procedural records of all EVT in the JR-NET and JR-NET2 databases. We assessed the features of the aneurysms and procedures, immediate radiographic findings, procedure-related complications, and clinical outcomes at 30 days after the procedures.Results We located 80.0% of UIAs in the anterior circulation, and the most frequent were paraclinoid. The diameter of 2.5%, 32.9%, 51.9%, 12.0%, and 0.7% of the UIAs was 20 mm, respectively. EVT failed in only 2.1%. Adjunctive techniques were applied in 54.8% of procedures. Pre- and postprocedural antiplatelet agents were prescribed in 85.6% and 84.0%, respectively, of the procedures. The immediate radiographic outcomes of 57.7%, 31.9%, and 10.0% of the UIAs comprised complete occlusion, residual necks, and residual aneurysms, respectively. Complications that were associated with 9.1% of procedures comprised 2.0% hemorrhagic and 4.6% ischemic, and the 30-day morbidity and mortality rates were 2.12% and 0.31%, respectively.Conclusions The radiographic results of EVT for asymptomatic UIAs in Japan were acceptable, with low mortality and morbidity rates.