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使用Matrix可脱卸弹簧圈治疗颅内动脉瘤的随访:单中心经验

Follow-up of intracranial aneurysms treated with matrix detachable coils: a single-center experience.

作者信息

Mitra D, Herwadkar A, Soh C, Gholkar A

机构信息

Department of Neuroradiology, Newcastle General Hospital, Newcastle upon Tyne, England.

出版信息

AJNR Am J Neuroradiol. 2007 Feb;28(2):362-7.

Abstract

BACKGROUND AND PURPOSE

Matrix coils are polymer-coated bioactive coils used in treatment of intracranial aneurysms. The current study is aimed at evaluating the efficacy and safety of these coils in treatment of ruptured and unruptured aneurysms.

METHODS

Seventy-seven consecutive patients with 84 aneurysms were included in the study. Forty-six aneurysms were treated with Matrix coils alone, and 38 were treated with Matrix coils in combination with other coils/devices. Angiographic follow-up was available in 64 patients with 70 aneurysms. Length of follow-up ranged from 6 to 28 months with mean of 10 months. Both postembolization and follow-up angiograms were graded on a 3-point Raymond scale. Aneurysms were classified as stable, improved, or recanalized based on the follow-up angiograms. Recanalization was considered major if it was saccular and its size would theoretically permit retreatment with coils.

RESULTS

At the end of the initial procedure, 47 (56.0%) aneurysms showed complete occlusion (Raymond 1), 20 (23.8%) showed contrast filling the neck of the aneurysm (Raymond 2), and 16 (19.0%) showed contrast filling the sac of the aneurysm (Raymond 3). Of the 70 aneurysms in which follow-up angiograms were available, 55.7% remained stable in appearance, 20.0% showed improved occlusion, and 24.3% demonstrated recanalization; 8.6% demonstrated major recanalization. There were 2 aneurysm rebleeds (both incompletely packed); one resulted in death.

CONCLUSION

Matrix coils are safe to use and the recanalization rate of aneurysms treated with these coils appears to be at least comparable with historical studies with Guglielmi detachable coils.

摘要

背景与目的

Matrix 线圈是用于治疗颅内动脉瘤的聚合物涂层生物活性线圈。本研究旨在评估这些线圈治疗破裂和未破裂动脉瘤的有效性和安全性。

方法

77 例连续患者共 84 个动脉瘤纳入本研究。46 个动脉瘤仅用 Matrix 线圈治疗,38 个动脉瘤用 Matrix 线圈联合其他线圈/装置治疗。64 例患者共 70 个动脉瘤有血管造影随访资料。随访时间为 6 至 28 个月,平均 10 个月。栓塞后及随访血管造影均按 3 分制 Raymond 分级。根据随访血管造影将动脉瘤分为稳定、改善或再通。若再通呈囊状且其大小理论上允许再次用线圈治疗,则认为是主要再通。

结果

在初始操作结束时,47 个(56.0%)动脉瘤显示完全闭塞(Raymond 1 级),20 个(23.8%)显示造影剂填充动脉瘤颈部(Raymond 2 级),16 个(19.0%)显示造影剂填充动脉瘤囊腔(Raymond 3 级)。在有随访血管造影资料的 70 个动脉瘤中,55.7%外观保持稳定,20.0%显示闭塞改善,24.3%出现再通;8.6%为主要再通。有 2 例动脉瘤再出血(均为填塞不完全);1 例导致死亡。

结论

Matrix 线圈使用安全,用这些线圈治疗的动脉瘤再通率似乎至少与 Guglielmi 可脱性线圈的既往研究相当。

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本文引用的文献

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