Intraprocedural cerebral aneurysm rupture during endovascular coiling.

Intraprocedural cerebral aneurysm rupture during endovascular coiling.
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血管内弹簧圈栓塞期间术中脑动脉瘤破裂。

DOI：
10.4103/0028-3886.82736
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发表时间：
2011
期刊：
Neurology India
影响因子：
2.7
通讯作者：
Yun
Yun
中科院分区：
医学4区
文献类型：
--
作者：
P. Zang;C. Liang;Q. Shi;Yun

文献摘要

被引文献

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背景 术中动脉瘤破裂被认为是脑动脉瘤血管内治疗最可怕的并发症之一，并与高死亡率相关。 目的 报告血管内弹簧圈栓塞术期间破裂的脑动脉瘤的临床结局。 患者和方法 在6年的时间内，对467例患者进行了559次血管内栓塞，其中507例脑动脉瘤。14例发生术中动脉瘤破裂（平均动脉瘤大小为3.8 mm）。在栓塞后至少3个月的随访血管造影片中，有11例存活患者。对急性和随访结果进行了审查。 结果 破裂动脉瘤与未破裂动脉瘤在血管内弹簧圈栓塞术中的动脉瘤穿孔率差异有统计学意义（P < 0.05）。有3例（21.4%）死亡与该并发症相关，3例（21.4%）患者出现新的功能障碍（改良兰金量表评分1 - 2）。栓塞的急性结果是：8例患者完全闭塞（57.1%），2例患者颈部残留（14.3%），4例患者不完全闭塞（28.6%）。11例存活患者的长期随访结果为：1例（9.1%）重度再通，1例（9.1%）轻度再通，9例（81.8%）稳定闭塞。 结论 术中动脉瘤破裂经常发生在小动脉瘤中，并且似乎与相对较高的死亡率相关。
BACKGROUND Intraprocedural aneurysm rupture is considered to be one of the most formidable complications of the endovascular treatment of cerebral aneurysms and is associated with high mortality. OBJECTIVE To report the clinical outcomes of cerebral aneurysms that ruptured during endovascular coiling. PATIENTS AND METHODS Over a period of six years, 559 endovascular embolizations were performed in 467 patients, with 507 cerebral aneurysms. Intraprocedural aneurysm rupture occurred in 14 cases (mean aneurysm size, 3.8 mm). Follow-up angiograms, at a minimum of three months post embolization, were available in 11 living patients. Acute and follow-up results were reviewed. RESULTS The difference in the rates of aneurysm perforation during endovascular coiling between ruptured and unruptured aneurysms was significant (P < 0.05). There were three (21.4%) deaths related to this complication and three (21.4%) patients developed new deficits (modified Rankin Scale scores 1 to 2). Acute results of embolization were: complete occlusion in eight (57.1%), neck remnant in two (14.3%), and incomplete occlusion in four (28.6%) patients. Long-term follow-up results in 11 living patients were: major recanalization in one (9.1%), minor recanalization in one (9.1%), and stable occlusion in nine (81.8%). CONCLUSION Intraprocedural aneurysm rupture frequently occurs in small aneurysms and appears to be associated with relatively high rates of mortality.