Lubicz Boris, Leclerc Xavier, Gauvrit Jean-Yves, Lejeune Jean-Paul, Pruvo Jean-Pierre
Department of Neuroradiology, Roger Salengro Hospital, University Hospital of Lille, France.
AJNR Am J Neuroradiol. 2004 Sep;25(8):1368-72.
Endovascular treatment with detachable coils is an accepted alternative to surgical clip placement for intracranial aneurysms. The purpose of this study was to evaluate the safety and reliability of the Sapphire coil, a new platinum coil for the treatment of intracranial aneurysms.
Between August and September 2003, 20 consecutive patients (13 women, seven men; mean age, 49 years; range, 33-77 years) with 20 intracranial aneurysms were referred to our department for endovascular treatment. Fifteen patients presented with subarachnoid hemorrhage, whereas five had asymptomatic, unruptured aneurysms. All patients were treated by selective endosaccular coil placement with the new coils. The remodeling technique was used in five wide-neck aneurysms. Clinical outcomes were assessed with the modified Glasgow Outcome Scale.
Aneurysmal occlusion with the new coils alone was successful in 16 patients and resulted in 12 complete occlusions and four neck remnants. Because of the limited Sapphire product line, additional Guglielmi detachable coils (GDCs) were required in four patients, two of whom received one 3D GDC of 3 mm diameter and two of whom received Ultra-Soft GDCs. Technical complication (stretching of a coil) occurred in one patient. Clinical outcomes were excellent in 14 patients and good in two.
Although the study was limited by its small patient population, the results show that selective endovascular treatment of intracranial aneurysms with Sapphire coils was not associated with an unexpected incidence of adverse events. Excellent anatomic and clinical results that were obtained in most patients suggest that Sapphire coils may have value in the treatment of intracranial aneurysms.
对于颅内动脉瘤，使用可脱卸弹簧圈进行血管内治疗是手术夹闭的一种公认替代方法。本研究的目的是评估用于治疗颅内动脉瘤的新型铂制弹簧圈——蓝宝石弹簧圈的安全性和可靠性。
2003年8月至9月期间，20例患有20个颅内动脉瘤的连续患者（13例女性，7例男性；平均年龄49岁；范围33 - 77岁）被转诊至我科接受血管内治疗。15例患者表现为蛛网膜下腔出血，而5例有无症状、未破裂的动脉瘤。所有患者均采用新型弹簧圈进行选择性囊内弹簧圈置入治疗。5个宽颈动脉瘤采用了重塑技术。采用改良格拉斯哥预后量表评估临床结局。
仅使用新型弹簧圈成功使16例患者的动脉瘤闭塞，其中12例完全闭塞，4例有颈部残余。由于蓝宝石产品线有限，4例患者需要额外使用 Guglielmi 可脱卸弹簧圈（GDC），其中2例接受了1个直径3 mm的3D GDC, 2例接受了超软GDC。1例患者发生技术并发症（弹簧圈拉伸）。14例患者临床结局优秀，2例良好。
尽管本研究受限于患者数量较少，但结果表明，使用蓝宝石弹簧圈对颅内动脉瘤进行选择性血管内治疗并未出现意外的不良事件发生率。大多数患者获得的优异解剖学和临床结果表明，蓝宝石弹簧圈在颅内动脉瘤治疗中可能具有价值。
