Department of Diagnostic and Interventional Radiology and Neuroradiology, HELIOS General Hospital Erfurt, Nordhäuser Str. 74, 99089, Erfurt, Germany.
Neuroradiology. 2010 May;52(5):349-59. doi: 10.1007/s00234-009-0568-x. Epub 2009 Jul 31.
The purpose of the study is to evaluate patients with wide-necked or complex aneurysms of the anterior circulation who underwent Solitaire AB Neurovascular Remodeling Device-assisted coil embolization.
From February 2008 to March 2009, consecutive data were collected from 45 patients with anterior circulation aneurysms. Eighteen of the patients presented with acute subarachnoid hemorrhage. Forty-six aneurysms were treated with the aid of different applications (n = 49) of the Solitaire AB Remodeling Device followed by standard coiling procedure (n = 43) using bioactive coils or/and bare coils.
Successful positioning of the remodeling device was obtained in 95.9% of the cases. There were two thromboembolic complications (4.1%) and one severe vasospasm requiring retrieval of the device. Permanent procedural morbidity was observed in one patient (2%). The proportion of patients in whom Raymond class 1 occlusion was obtained was 53.5% (n = 23). Raymond class 2 occlusion was achieved in 42% (n = 18) and Raymond class 3 occlusion in 4.7% (n = 2). Thirty-nine patients left the hospital with a good clinical status.
The initial technical and clinical results of Solitaire AB device-assisted coiling of aneurysms in the anterior circulation are highly encouraging. This technique may enhance the possibilities of the endovascular treatment of these aneurysms in clinical routine.
本研究的目的是评估接受 Solitaire AB 神经血管重塑装置辅助线圈栓塞治疗的宽颈或复杂前循环动脉瘤患者。
从 2008 年 2 月至 2009 年 3 月,连续收集了 45 例前循环动脉瘤患者的数据。其中 18 例患者出现急性蛛网膜下腔出血。46 个动脉瘤采用不同应用(n = 49)的 Solitaire AB 重塑装置辅助治疗,随后采用生物活性线圈和/或裸线圈进行标准线圈栓塞术(n = 43)。
95.9%的病例成功定位了重塑装置。有 2 例血栓栓塞并发症(4.1%)和 1 例严重血管痉挛需要取出装置。1 例患者发生永久性手术并发症(2%)。获得 Raymond 分级 1 级闭塞的患者比例为 53.5%(n = 23)。Raymond 分级 2 级闭塞为 42%(n = 18),Raymond 分级 3 级闭塞为 4.7%(n = 2)。39 例患者临床状况良好出院。
Solitaire AB 装置辅助前循环动脉瘤线圈栓塞的初始技术和临床结果令人鼓舞。该技术可能增强这些动脉瘤在临床常规中经血管内治疗的可能性。