Slob Marjan J, Sluzewski Menno, van Rooij Willem Jan
Department of Radiology, St. Elisabeth Ziekenhuis, GC Tilburg, The Netherlands.
Neuroradiology. 2005 Dec;47(12):942-5. doi: 10.1007/s00234-005-1446-9.
We evaluated prospectively the relation between packing and reopening in coiled intracranial aneurysms. Packing, defined as the ratio between the volume of inserted coils and volume of the aneurysm expressed as percentage, was calculated for 82 intracranial aneurysms treated with detachable coils. Aneurysm volume was assessed from 3D angiography. Reopening of the aneurysmal lumen at the 6-month follow-up angiography was dichotomized into present or absent. We assessed whether packing above 24% protected against reopening. Twenty-three of 82 aneurysms (28%) showed reopening. Reopening was caused by compaction in 20 aneurysms and by partial thrombosis, undetected at the time of initial treatment in three aneurysms. Three of 29 aneurysms (10%) with a packing of more than 24% showed reopening. These three aneurysms contained partially intraluminal thrombosis undetected at the time of treatment. We conclude that in coiled intracranial aneurysms packing above 24% protects against reopening by compaction in non-thrombosed aneurysms. Since intraluminal thrombosis may go undetected at the time of treatment, follow-up angiography is still warranted in aneurysms with packing densities greater than 24%.
我们前瞻性地评估了颅内盘绕型动脉瘤的填塞与再通之间的关系。对于82例采用可脱卸弹簧圈治疗的颅内动脉瘤，计算其填塞率（定义为插入弹簧圈的体积与动脉瘤体积之比，以百分比表示）。动脉瘤体积通过三维血管造影进行评估。将6个月随访血管造影时动脉瘤腔的再通情况分为存在或不存在。我们评估了填塞率高于24%是否能防止再通。82例动脉瘤中有23例（28%）出现再通。20例动脉瘤的再通是由弹簧圈压缩引起的，3例动脉瘤的再通是由初始治疗时未检测到的部分血栓形成引起的。29例填塞率超过24%的动脉瘤中有3例（10%）出现再通。这3例动脉瘤在治疗时存在未被检测到的部分腔内血栓形成。我们得出结论，在颅内盘绕型动脉瘤中，填塞率高于24%可防止非血栓形成动脉瘤因弹簧圈压缩而出现再通。由于治疗时可能未检测到腔内血栓形成，对于填塞密度大于24%的动脉瘤，仍有必要进行随访血管造影。
