Predisposing factors for recanalization of cerebral aneurysms after endovascular embolization: a multivariate study.
Predisposing factors for recanalization of cerebral aneurysms after endovascular embolization: a multivariate study.
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脑动脉瘤血管内栓塞术后再通的诱发因素：多因素研究
DOI：
10.1136/neurintsurg-2017-013041
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发表时间：
2018-03
影响因子：
4.8
通讯作者：
Yang X
中科院分区：
文献类型：
--
作者：
Zhang Q;Jing L;Liu J;Wang K;Zhang Y;Paliwal N;Meng H;Wang Y;Wang S;Yang X
血管内栓塞术(栓塞术或支架辅助栓塞术)后脑动脉瘤的再通一直是一个令人担忧的问题。我们在一个大的患者队列中使用多维分析系统地评估了脑动脉瘤再通的易感因素。在238例283个动脉瘤患者中，比较血管再通组和非再通组患者的基线特征、动脉瘤形态特征、治疗相关因素以及血管内治疗(介入或支架辅助介入)后血流动力学的变化。多因素Logistic回归分析确定与血管再通相关的独立危险因素。栓塞组再通16个，复发率18.6%；支架辅助栓塞组再通24个，再通率12.2%。在再通组和未再通组中，大动脉瘤(>；10 mm，P=0.002)和随访间隔>；1年(P=0.027)有统计学意义。在血流动力学变化方面，血管再通组血管内治疗后3个参数(颈平面血流速度、颈壁切应力和整个动脉瘤壁切应力)的下降幅度相对较小。有趣的是，治疗后颈平面上的速度和颈壁上的壁面剪应力可能会增加。颈平面血流速度RR在多因素分析中有显著差异(P=0.013)，是血管再通的独立危险因素。除动脉瘤大小和随访时间外，血流动力学改变，尤其是颈平面血流速度RR在动脉瘤再通中起重要作用。
The recanalization of cerebral aneurysm after endovascular embolization (coiling or stent-assisted coiling) has been a matter of concern. We systematically evaluated the predisposing factors for cerebral aneurysm recanalization using multidimensional analysis in a large patient cohort. In 238 patients with 283 aneurysms, patient baseline characteristics, aneurysm morphological characteristics, treatment-related factors, and changes in flow hemodynamics after endovascular treatment (coiling or stent-assisted coiling) were compared between the recanalization and non-recanalization groups. Multivariate logistic regression analysis was performed to determine independent risk factors correlated with recanalization. 16 aneurysms treated by coiling recanalized, with a recurrence rate of 18.6%, and 24 recanalized in the lesions treated by stent-assisted coiling, with a recanalization rate of 12.2%. Large aneurysm (>10 mm, P=0.002) and follow-up interval >1 year (P=0.027) were demonstrated statistically significant between the recanalization and non-recanalization groups. Regarding flow hemodynamics changes, three parameters (velocity on the neck plane, wall shear stress on the neck wall and wall shear stress on the whole aneurysm) showed relatively lower amplitude of decrease after endovascular treatment in the recanalization group. Interestingly, the velocity on the neck plane and wall shear stress on the neck wall may elevated after treatment. Specifically, the RR of velocity on the neck plane showed significant difference in the multivariate analysis (P=0.013), which was considered an independent risk factor for recanalization. Besides the aneurysm size and follow-up interval, flow hemodynamic changes, especially the RR of velocity on the neck plane, played important roles in aneurysm recanalization.
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血流动力学对支架辅助弹簧圈栓塞后次全闭塞床突旁动脉瘤结局的影响。
影响因子：
4.8
作者：
Liu J;Jing L;Wang C;Paliwal N;Wang S;Zhang Y;Xiang J;Siddiqui AH;Meng H;Yang X
通讯作者：
Yang X
影响因子：
7.4
作者：
Wang C;Tian Z;Liu J;Jing L;Paliwal N;Wang S;Zhang Y;Xiang J;Siddiqui AH;Meng H;Yang X
通讯作者：
Yang X
基于模型的脑动脉瘤自膨式支架快速虚拟部署实验验证
影响因子：
3.9
作者：
Zhang Q;Meng Z;Zhang Y;Yao K;Liu J;Zhang Y;Jing L;Yang X;Paliwal N;Meng H;Wang S
通讯作者：
Wang S
DOI：
10.4103/1793-5482.103706
发表时间：
2012-07
期刊：
Asian journal of neurosurgery
影响因子：
--
作者：
Irie K;Anzai H;Kojima M;Honjo N;Ohta M;Hirose Y;Negoro M
通讯作者：
Negoro M
影响因子：
4.8
作者：
Dorfer, Christian;Gruber, Andreas;Knosp, Engelbert
通讯作者：
Knosp, Engelbert