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使用基质线圈进行颅内动脉瘤的囊内治疗:早期经验及中期随访

Endosaccular treatment of intracranial aneurysms using matrix coils: early experience and midterm follow-up.

作者信息

Niimi Yasunari, Song Joon, Madrid Mary, Berenstein Alejandro

机构信息

Center for Endovascular Surgery, Hyman-Newman Institute of Neurology and Neurosurgery, Roosevelt Hospital, New York, NY 10019, USA.

出版信息

Stroke. 2006 Apr;37(4):1028-32. doi: 10.1161/01.STR.0000206459.73897.a3. Epub 2006 Mar 2.

Abstract

BACKGROUND AND PURPOSE

The authors report their experience using Matrix coils in the treatment of cerebral aneurysms.

METHODS

The outcomes of 72 consecutive patients (76 aneurysms) who underwent coiling using Matrix coils at our institution were retrospectively analyzed.

RESULTS

Seventy-four aneurysms in 70 patients were coiled using Matrix coils (ranging 3% to 100% by coil length; mean 68.8%). Two patients underwent regular platinum coil embolization after failed Matrix coil placement. Thirty-two (42%) ruptured aneurysms were acutely treated. In 46 aneurysms, Matrix composed >50% of coil length. Complete aneurysm occlusion was obtained in 13 aneurysms (17.6%), neck remnant in 30 (40.5%), and dome filling in 31 (41.9%). Procedural morbidity and mortality rates were 1.4% and 1.4%, respectively. Angiographic follow-up was obtained in 63.5% (47 of 74 aneurysms; average 12.2 months; range 0 to 34). In these 47 angiographically followed aneurysms, the overall recanalization rate was 57.4%. In aneurysms with >50% Matrix coils, 76.1% had angiographic follow-up (35 of 46), and in this group, the overall recanalization rate was 54.3% (19 of 35): 25% (1 of 4) for very small (<5 mm); 33% (4 of 12) for small-size (<10 mm)/small-neck (<4 mm); and 63% (5 of 8) for small-size/wide-neck (> or =4 mm). A total of 82% (9 of 11) recanalization occurred in large aneurysms (> or =10 to 25 mm). Ten aneurysms (21.3%; 10 of 47) underwent retreatment. Clinical follow-up was obtained in 61 (86%) patients (average 15 months; range 1 to 37): 87% of patients were Glasgow Outcome Scale 4 or 5.

CONCLUSIONS

The use of Matrix coils resulted in worse recanalization rates than that reported for Guglielmi detachable bare platinum coils.

摘要

背景与目的

作者报告了他们使用Matrix线圈治疗脑动脉瘤的经验。

方法

回顾性分析了在我们机构连续72例(76个动脉瘤)接受使用Matrix线圈进行栓塞治疗的患者的结果。

结果

70例患者中的74个动脉瘤使用Matrix线圈进行了栓塞(线圈长度占比3%至100%;平均68.8%)。2例患者在Matrix线圈放置失败后接受了常规铂线圈栓塞。32个(42%)破裂动脉瘤接受了急诊治疗。在46个动脉瘤中,Matrix线圈长度占比>50%。13个动脉瘤(17.6%)实现了动脉瘤完全闭塞,30个(40.5%)有颈部残留,31个(41.9%)为瘤顶填充。手术并发症发生率和死亡率分别为1.4%和1.4%。63.5%(74个动脉瘤中的47个)进行了血管造影随访(平均12.2个月;范围0至34个月)。在这47个接受血管造影随访的动脉瘤中,总体再通率为57.4%。在Matrix线圈长度占比>50%的动脉瘤中,76.1%(46个中的35个)进行了血管造影随访,在该组中,总体再通率为54.3%(35个中的19个):极小(<5mm)动脉瘤为25%(4个中的1个);小尺寸(<10mm)/小颈宽(<4mm)动脉瘤为33%(12个中的4个);小尺寸/宽颈宽(≥4mm)动脉瘤为63%(8个中的5个)。大动脉瘤(≥10至25mm)中共有82%(11个中的9个)发生再通。10个动脉瘤(21.3%;47个中的10个)接受了再次治疗。61例(86%)患者获得了临床随访(平均15个月;范围1至37个月):87%的患者格拉斯哥预后评分4或5分。

结论

与 Guglielmi 可解脱裸铂线圈相比,使用Matrix线圈导致的再通率更高。

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