Relationship of A1 Segment Hypoplasia with the Radiologic and Clinical Outcomes of Surgical Clipping of Anterior Communicating Artery Aneurysms
Relationship of A1 Segment Hypoplasia with the Radiologic and Clinical Outcomes of Surgical Clipping of Anterior Communicating Artery Aneurysms
复制标题
A1 段发育不全与前交通动脉瘤手术夹闭的影像学和临床结果的关系
DOI：
10.1016/j.wneu.2017.07.122
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发表时间：
2017
影响因子：
2
通讯作者：
Wang Shuo
中科院分区：
文献类型：
--
作者：
Yang Fan;Li Hao;Wu Jun;Li Maogui;Chen Xin;Jiang Pengjun;Li Zhengsong;Cao Yong;Wang Shuo
目的探讨A1段发育不全是否是前交通动脉（ACoA）动脉瘤手术夹闭术不良影像学和临床结果的危险因素。方法回顾性分析2011年9月至2016年9月在北京天坛医院接受手术夹闭术的251例ACoA动脉瘤患者的临床和影像学特征以及临床结果。此外，还进行单变量和多变量Logistic回归分析，以确定术后梗塞和手术夹闭ACoA动脉瘤的不良临床结果的独立危险因素。结果A1段发育不全的发生率为49.8%（251名患者中的125名）。单因素分析显示，多发性动脉瘤（P=0.025）、动脉瘤直径（P=0.040）和A1段发育不全（P=0.010）与大脑前动脉（ACA）区域梗死相关，其中A1段发育不全（P=0.002）与手术夹闭ACoA动脉瘤的不良临床结果显着相关。此外，多变量分析显示，多发性动脉瘤（P = 0.038；优势比[OR]，2.571）、动脉瘤直径（P = 0.034；OR，1.097）和A1段发育不全（P = 0.007；OR，3.619）是ACA区域梗塞的强独立危险因素。此外，Hunt和Hess评分（P=0.036；OR，2.326）和A1段发育不全（P=0.002；OR，2.873）是手术夹闭ACoA动脉瘤临床不良结果的显着独立危险因素。结论A1段发育不全是手术夹闭ACoA动脉瘤和ACA临床不良结果的显着独立危险因素。手术后梗塞。
ObjectiveThis study aims to assess whether the A1 segment hypoplasia is a risk factor for unfavorable radiologic and clinical outcomes of surgical clipping anterior communicating artery (ACoA) aneurysm.MethodsWe retrospectively reviewed 251 patients with ACoA aneurysm who underwent surgical clipping in Beijing Tiantan Hospital between September 2011 and September 2016. Their clinical and radiologic features, as well as clinical outcomes, were reviewed. In addition, univariate and multivariate logistic regression analysis was performed to identify independent risk factors for the postoperative infarction and unfavorable clinical outcomes of surgical clipping ACoA aneurysm.ResultsThe incidence of A1 segment hypoplasia was 49.8% (125 of 251 patients). Univariate analysis showed that multiple aneurysm (P= 0.025), diameter of aneurysm (P= 0.040), and A1 segment hypoplasia (P= 0.010) were associated with anterior cerebral artery (ACA) territories infarction, and A1 segment hypoplasia (P= 0.002) is significantly correlated with unfavorable clinical outcomes of surgical clipping ACoA aneurysm. Moreover, multivariate analysis showed that multiple aneurysm (P= 0.038; odds ratio [OR], 2.571), diameter of aneurysm (P= 0.034; OR, 1.097), and A1 segment hypoplasia (P= 0.007; OR, 3.619) were strongly independent risk factors for ACA territories infarction. In addition, Hunt and Hess scores (P= 0.036; OR, 2.326) and A1 segment hypoplasia (P= 0.002; OR, 2.873) are significant independent risk factors for unfavorable clinical outcomes of surgical clipping ACoA aneurysm.ConclusionsA1 segment hypoplasia is a significant independent risk factor for unfavorable clinical outcomes of surgical clipping ACoA aneurysm and ACA infarction after surgery.