Yan Bernard, de Rochement Richard du Mesnil, Raabe Andreas, Zanella Friedhelm, Berkefeld Joachim
Institute of Neuroradiology, JWGU, Frankfurt am Main, Germany.
Neuroradiology. 2006 Apr;48(4):264-8. doi: 10.1007/s00234-005-0029-0. Epub 2006 Mar 15.
Endovascular coiling has become a powerful alternative to neurosurgical clipping of cerebral aneurysms. Apart from the Guglielmi Detachable Coil (GDC) (Boston Scientific, Galway, Ireland), there is limited published data about the newer generation of detachable platinum coils, e.g., TruFill (Cordis, Johnson and Johnson, Miami, Fl.). We report our initial clinical experience with the embolization of aneurysms by TruFill coils. Included in this retrospective study were 26 patients (age 55.4+/-14.5 years; 9 male, 17 female) with 28 aneurysms, 21 ruptured and 7 unruptured. All patients were treated exclusively by embolization with TruFill platinum coils. Immediate angiographic and 6-month angiographic follow-up results were documented. Acute clinical outcome was recorded. Of the 28 aneurysms, 16 (57%) were completely occluded by TruFill embolization, 11 (39%) were incompletely occluded with residual necks, and 1 (4%) was partially occluded as residual aneurysm. There were no aneurysmal ruptures during the procedures. Follow-up at 6 months after the procedure was available in 18 patients and 19 aneurysms. Of the 19 aneurysms, 2 of 12 initially completely occluded aneurysms (17%) and 1 of 7 aneurysms with initial residual necks (14%) showed recanalization at the 6-month follow-up. One recanalized aneurysm was subsequently recoiled with consequent residual neck and remained unchanged at the 1-year follow-up. Embolization by TruFill platinum coils has a comparable total aneurysmal occlusion rate to that with GDC. The mid-term reintervention rate is low, and will require verification by future long-term studies.
血管内栓塞术已成为脑动脉瘤神经外科夹闭术的一种有力替代方法。除了 Guglielmi 可脱性弹簧圈(GDC)(波士顿科学公司,爱尔兰戈尔韦)外,关于新一代可脱性铂弹簧圈,如 TruFill(柯惠医疗,强生公司,美国佛罗里达州迈阿密)的已发表数据有限。我们报告了使用 TruFill 弹簧圈栓塞动脉瘤的初步临床经验。这项回顾性研究纳入了 26 例患者(年龄 55.4±14.5 岁;男性 9 例,女性 17 例),共 28 个动脉瘤,其中 21 个为破裂动脉瘤,7 个为未破裂动脉瘤。所有患者均仅接受 TruFill 铂弹簧圈栓塞治疗。记录了即刻血管造影和 6 个月血管造影随访结果。记录了急性临床结局。在 28 个动脉瘤中,16 个(57%)通过 TruFill 栓塞完全闭塞,11 个(39%)未完全闭塞,有残余瘤颈,1 个(4%)部分闭塞,为残余动脉瘤。手术过程中无动脉瘤破裂。18 例患者和 19 个动脉瘤有术后 6 个月的随访资料。在 19 个动脉瘤中,12 个最初完全闭塞的动脉瘤中有 2 个(17%)以及 7 个最初有残余瘤颈的动脉瘤中有 1 个(14%)在 6 个月随访时出现再通。1 个再通的动脉瘤随后再次栓塞,仍有残余瘤颈,在 1 年随访时保持不变。TruFill 铂弹簧圈栓塞术的动脉瘤总闭塞率与 GDC 相当。中期再干预率较低,未来需要长期研究加以验证。