Midterm outcomes of intracranial aneurysms with bleb formation with densely coiling of the aneurismal neck or entire aneurysm.
Midterm outcomes of intracranial aneurysms with bleb formation with densely coiling of the aneurismal neck or entire aneurysm.
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颅内动脉瘤伴气泡形成并致密盘绕动脉瘤颈或整个动脉瘤的中期结果
DOI：
10.1097/md.0000000000007046
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发表时间：
2017-08
期刊：
影响因子：
1.6
通讯作者：
Jiang Y
中科院分区：
文献类型：
--
作者：
Wan J;Zhang L;Lu G;Gu W;Huang L;Ge L;Zhang X;Ji L;Chen Q;Di R;Jiang Y
摘要 评价动脉瘤颈栓塞是否优于整个动脉瘤栓塞的疗效和安全性。先前的研究发现，动脉瘤颈栓塞可用于治疗破裂并形成气泡的颅内动脉瘤。选取2014年1月至2015年8月在上海市静安区中心医院接受血管内栓塞治疗的163例破裂伴滤泡形成的动脉瘤患者分为动脉瘤颈栓塞组（颈组87例）和整个动脉瘤栓塞组（动脉瘤组76例）。对临床数据、随访格拉斯哥结果量表（GOS）评分以及并发症发生情况进行回顾性分析。比较不同栓塞对预后的影响。颈部组和动脉瘤组的中位随访时间分别为 17 个月 (9.62) 和 16.5 个月 (9.54) (P = .799)。两组间复发情况、术后GOS评分以及末次随访时GOS评分均无差异。颈部组的线圈数量和手术并发症均少于动脉瘤组（分别为P < .001和P < .030）。调整年龄和性别后，发现栓塞方法是手术相关并发症的独立预测因素（比值比 2.419，95% 置信区间 1.111–5.269，P = .026）。栓塞动脉瘤颈时的弹簧圈数量和手术相关并发症比栓塞整个动脉瘤时要少，显示了动脉瘤颈栓塞的潜在优势。
Abstract To evaluate whether the efficacy and safety of embolization of the aneurysmal neck were better than those of embolization of the entire aneurysm. Previous studies found that embolization of the aneurysmal neck can be used for treating ruptured intracranial aneurysm with bleb formation. In all, 163 patients with ruptured aneurysms with bleb formation who underwent endovascular embolization at the Shanghai Municipal Jing’an District Central Hospital from January 2014 to August 2015 were divided into the embolization of aneurysmal neck group (neck group; 87 cases) and embolization of entire aneurysm group (aneurysm group; 76 cases). A retrospective analysis of clinical data, follow-up Glasgow Outcome Scale (GOS) score, and occurrence of complications was performed. The impacts of different embolisms on the prognosis were compared. The median follow-up time in the neck and aneurysm groups was 17 months (9.62) and 16.5 months (9.54), respectively (P = .799). No differences were found in recurrence, postoperative GOS score, and GOS score at the last follow-up between the 2 groups. The numbers of coils and surgical complications in the neck group were smaller than those in the aneurysm group (P < .001 and P < .030, respectively). After adjusting for age and sex, the embolization method was found to be an independent predictor for surgery-related complications (odds ratio 2.419, 95% confidence interval 1.111–5.269, P = .026). The numbers of coils and surgery-related complications were smaller when embolizing the aneurysmal neck than the entire aneurysm, showing potential advantages of embolization of the aneurysmal neck.