Additional coiling of previously coiled cerebral aneurysms: clinical and angiographic results.
Additional coiling of previously coiled cerebral aneurysms: clinical and angiographic results.
复制标题
先前盘绕的脑动脉瘤的额外盘绕：临床和血管造影结果。
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
G. Rinkel
中科院分区：
文献类型：
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作者：
M. Slob;M. Sluzewski;W. V. van Rooij;G. Roks;G. Rinkel
背景和目的
一些已经盘绕的脑动脉瘤随着时间的推移会重新开放，并应考虑进行额外的治疗，以降低复发性出血的风险。我们的目的是评估先前盘绕但重新打开的动脉瘤患者额外盘绕的手术并发症和血管造影结果，并评估对（再）出血的保护作用。
方法
我们比较了 439 名患者的 488 个动脉瘤的初始弹簧圈栓塞术与 40 名患者的 41 个重新打开的动脉瘤的 53 个附加弹簧圈栓塞术的手术并发症。评估额外线圈的血管造影结果。我们将额外弹簧圈栓塞后完全或接近完全动脉瘤闭塞的患者与未接受额外治疗或额外弹簧圈栓塞后仍不完全闭塞的动脉瘤不完全闭塞患者在 6 个月随访血管造影中进行了比较。
结果
488 例初始弹簧圈栓塞手术中出现了 35 例手术并发症，另外 53 例手术中没有出现并发症。 41 个动脉瘤中有 31 个 (76%) 在额外弹簧圈后获得完全或接近完全的血管造影闭塞。 29 名动脉瘤不完全闭塞的患者中有 2 名发生了再出血，但在额外弹簧圈栓塞后完全或接近完全闭塞的 31 名患者中没有发生再出血。
结论
对先前盘绕的动脉瘤进行额外的盘绕具有较低的手术并发症发生率，并且可以使大多数动脉瘤充分闭塞。数据表明，成功的额外线圈可降低再出血的风险。
BACKGROUND AND PURPOSE
Some cerebral aneurysms that have been coiled reopen over time and additional treatment should be considered to reduce the risk of recurrent hemorrhage. Our purpose was to assess procedural complications and angiographic results of additional coiling in patients with previously coiled but reopened aneurysms and to evaluate protection against (re)bleeding.
METHODS
We compared procedural complications of initial coiling of 488 aneurysms in 439 patients with those of 53 additional coiling procedures in 41 reopened aneurysms in 40 patients. Angiographic results of additional coiling were assessed. We compared episodes of (re)bleeding in patients with complete or near-complete aneurysm occlusion after additional coiling with those of patients with incomplete aneurysm occlusion at 6-month follow-up angiography who were not additionally treated or who still had incomplete occlusion after additional coiling.
RESULTS
Thirty-five procedural complications occurred in 488 initial coiling procedures, and no complications occurred in 53 additional procedures. Complete or near-complete angiographic occlusion after additional coiling was obtained in 31 (76%) of 41 aneurysms. Rebleeding occurred in two of 29 patients with incomplete aneurysm occlusion but in none of the 31 patients with complete or near-complete occlusion after additional coiling.
CONCLUSION
Additional coiling of previously coiled aneurysms has a low procedural complication rate and leads to sufficient occlusion in most aneurysms. The data indicate that successful additional coiling decreases the risk of rebleeding.