Endovascular Treatment of Intracranial Aneurysms with Matrix Detachable Coils: Midterm Anatomic Follow-Up from a Prospective Multicenter Registry
Endovascular Treatment of Intracranial Aneurysms with Matrix Detachable Coils: Midterm Anatomic Follow-Up from a Prospective Multicenter Registry
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使用基质可拆卸弹簧圈对颅内动脉瘤进行血管内治疗：前瞻性多中心注册中心的中期解剖随访
DOI：
10.3174/ajnr.a0738
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发表时间：
2008
影响因子：
3.5
通讯作者：
Serge Bracard
中科院分区：
文献类型：
--
作者：
L. Pierot;Xavier Leclerc;A. Bonafé;Serge Bracard
背景和目的：聚乙醇酸/聚乳酸覆盖的铂弹簧圈已被提议用于降低血管内治疗后动脉瘤的再通率。在法国进行了一项前瞻性多中心登记，以评估 Matrix 弹簧圈的安全性以及短期和中期疗效。该分析侧重于解剖中期结果。材料和方法：本登记中纳入了 236 名患有 244 个破裂或未破裂动脉瘤的患者，他们使用 Matrix 弹簧圈通过血管内方法进行了治疗。治疗全部或部分通过使用矩阵线圈进行。使用雷蒙德量表对术后和末次随访数字减影血管造影（DSA）的解剖结果进行评估。 “再通”被定义为恶化，“进行性血栓形成”被定义为雷蒙德量表的改善。结果：236 名患有 171 个动脉瘤的患者中，有 165 名 (70%) 获得了解剖学中期随访（范围为 6-27 个月；平均为 14 ± 4 个月）。中期随访血管造影显示，79 例动脉瘤完全闭塞（46.2%），43 例有颈部残余（25.1%），49 例有动脉瘤残余（28.7%）。在 171 个动脉瘤中，44 名患者（25.7%）观察到再通，其中 18 名患者（10.5%）出现严重再通。如果动脉瘤栓塞体积≤25%，则再通更加频繁。在 52 个动脉瘤 (30%) 中观察到进行性血栓形成。随访期间未观察到出血或再出血。结论：Matrix 弹簧圈在预防血管再通方面的功效并未在我们的系列中得到证实。与之前使用裸铂线圈的研究一致，体积闭塞是预测动脉瘤再通的一个重要特征。在我们的系列中观察到未完全治疗的动脉瘤中进行性血栓形成的比例很高，这表明 Matrix 弹簧圈具有生物活性。
BACKGROUND AND PURPOSE: Polyglycolic/polylactic acid–covered platinum coils have been proposed to reduce the rate of aneurysm recanalization after endovascular treatment. A prospective and multicenter registry was conducted in France to evaluate the safety and short-term and midterm efficacy of Matrix coils. This analysis focused on anatomic midterm results. MATERIALS AND METHODS: Two hundred thirty-six patients harboring 244 ruptured or unruptured aneurysms treated via endovascular approach by using Matrix coils were included in this registry. Treatment was totally or partially performed by using Matrix coils. Anatomic results were evaluated on postoperative and last-follow-up digital subtraction angiography (DSA) by using the Raymond scale. “Recanalization” was defined as worsening, and “progressive thrombosis” was defined as improvement on the Raymond scale. RESULTS: Anatomic midterm follow-up was obtained in 165 of 236 patients (70%) harboring 171 aneurysms (range, 6–27 months; mean, 14 ± 4 months). At midterm follow-up angiography, 79 aneurysms were completely occluded (46.2%), 43 had a neck remnant (25.1%), and 49 had an aneurysm remnant (28.7%). Of 171 aneurysms, recanalization was observed in 44 patients (25.7%), including major recanalization in 18 patients (10.5%). Recanalization was more frequent if the embolized volume of aneurysm was ≤25%. Progressive thrombosis was observed in 52 aneurysms (30%). No bleeding or rebleeding was observed during the period of follow-up. CONCLUSION: The efficacy of Matrix coils in preventing recanalization was not demonstrated in our series. In agreement with previous studies using bare platinum coils, volumic occlusion was an important feature for the prediction of aneurysm recanalization. A high percentage of progressive thrombosis in incompletely treated aneurysms was observed in our series, suggesting a biologic activity of Matrix coils.