Albayram Sait, Selcuk Hakan, Kara Batuhan, Bozdag Erhan, Uzma Omer, Kocer Naci, Islak Civan
Istanbul University, Cerrahpasa Medical School, Department of Radiology, Division of Neuroradiology, 34300 Kocamustafapasa, Istanbul, Turkey.
AJNR Am J Neuroradiol. 2004 Nov-Dec;25(10):1768-77.
Thromboembolic events may occur during or after the treatment of intracranial aneurysms with Guglielmi detachable coils (GDCs). The purpose of this study was to determine the frequency of thromboembolic events associated with balloon-assisted coil placement and to investigate possible risk factors for these events during balloon-assisted coil placement and embolization.
Twenty patients with cerebral aneurysms treated with balloon-assisted coil placement and embolization at our institution were included. All patients underwent diffusion-weighted (DW) imaging within 6 hours after the procedure. Two neuroradiologists reviewed all DW images to detect ischemic lesions.
Hyperintense lesions compatible with thromboembolic events were detected on DW images of four (20%) patients. Three lesions were in the territory of posterior circulation, and one was in the territory of anterior circulation. The occurrence of new lesions was strongly associated with the number of times the microcatheter or coil was repositioned and removed and with the size of the aneurysmal neck (P < .01). DW imaging findings did not suggest a strong correlation between the occurrence of new ischemic lesions and potential risk factors (maximum balloon inflation time, number of times the balloon was inflated, etc.) associated with balloon-assisted coil placement and embolization (P > .05).
The risk of thromboembolic events during the treatment of intracranial aneurysms with balloon-assisted techniques is not more significant than when conventional GDC techniques are used. The only variables found to influence this risk during or after balloon-assisted coil placement were microcatheter repositioning, coil removal and repositioning, and size of the aneurysmal neck.
使用 Guglielmi 可解脱弹簧圈（GDC）治疗颅内动脉瘤期间或之后可能发生血栓栓塞事件。本研究的目的是确定与球囊辅助弹簧圈置入相关的血栓栓塞事件的发生率，并调查球囊辅助弹簧圈置入及栓塞过程中这些事件的可能危险因素。
纳入在本机构接受球囊辅助弹簧圈置入及栓塞治疗的 20 例脑动脉瘤患者。所有患者在术后 6 小时内接受弥散加权（DW）成像。两名神经放射科医生审查所有 DW 图像以检测缺血性病变。
在 4 例（20%）患者的 DW 图像上检测到与血栓栓塞事件相符的高信号病变。3 个病变位于后循环区域，1 个位于前循环区域。新病变的出现与微导管或弹簧圈重新定位和取出的次数以及瘤颈大小密切相关（P <.01）。DW 成像结果未提示新的缺血性病变的发生与球囊辅助弹簧圈置入及栓塞相关的潜在危险因素（最大球囊充盈时间、球囊充盈次数等）之间存在强相关性（P >.05）。
使用球囊辅助技术治疗颅内动脉瘤期间血栓栓塞事件的风险并不比使用传统 GDC 技术时更高。在球囊辅助弹簧圈置入期间或之后发现影响该风险的唯一变量是微导管重新定位、弹簧圈取出和重新定位以及瘤颈大小。
