破裂颅内动脉瘤血管内治疗后的即刻解剖结果：CLARITY 系列分析。
Immediate anatomic results after the endovascular treatment of ruptured intracranial aneurysms: analysis in the CLARITY series.
机构信息
Department of Neuroradiology, Maison Blanche Hospital, CHU Reims, Reims, France.
出版信息
AJNR Am J Neuroradiol. 2010 May;31(5):907-11. doi: 10.3174/ajnr.A1954. Epub 2010 Jan 14.
BACKGROUND AND PURPOSE
The efficacy of the endovascular treatment in providing stable occlusion of intracranial aneurysms is still controversial and should be precisely analyzed. A first step is to carefully study immediate anatomical results. CLARITY (Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms) is a prospective multicenter consecutive series including patients treated by coiling for ruptured aneurysms. Immediate anatomic results are presented.
MATERIALS AND METHODS
Postoperative anatomic results were evaluated by DSA by the treating physician and anonymously and independently by 2 experienced neuroradiologists by using the 3-point Montreal Scale. Patients were divided into 2 groups: patients treated with GDC and those treated with Matrix detachable coils.
RESULTS
A total of 773 patients (461 women, 312 men; 19-80 years of age; mean, 51.2 +/- 13.2 years) with 773 ruptured aneurysms were included in the study. The rate of occlusion as determined by the treating physician was designated complete for 586 aneurysms (75.8%), neck remnant for 145 aneurysms (18.8%), and aneurysm remnant for 42 aneurysms (5.4%). The same evaluation as reported by the 2 independent reviewers was complete occlusion for 366 aneurysms (47.4%), neck remnant for 324 aneurysms (41.9%), and aneurysm remnant for 83 aneurysms (10.7%). Postoperative anatomic results were significantly linked to age but not to the technique of endovascular treatment or aneurysm characteristics (location, size, dome-to neck ratio). Results were not significantly different between the GDC and Matrix group.
CONCLUSIONS
Endovascular treatment of ruptured intracranial aneurysms resulted in a high rate of satisfactory occlusion (complete occlusion and neck remnant in 89.3%). Patient age was the only factor associated with the rate of occlusion. The rate of aneurysm occlusion differed insignificantly between GDC and Matrix coils.
背景与目的
血管内治疗对于颅内动脉瘤稳定闭塞的疗效仍存在争议，需要进行精确分析。第一步是仔细研究即刻解剖学结果。CLARITY（破裂颅内动脉瘤治疗的临床和解剖学结果）是一项前瞻性多中心连续系列研究，纳入了接受线圈栓塞治疗的破裂动脉瘤患者。本研究旨在呈现即刻解剖学结果。
材料与方法
由治疗医生和 2 位经验丰富的神经放射学家分别匿名和独立地使用 3 分 Montreal 量表对术后解剖学结果进行评估。根据所用的栓塞材料，将患者分为 GDC 组和 Matrix 可解脱弹簧圈组。
结果
共纳入 773 例（461 例女性，312 例男性；年龄 19-80 岁；平均年龄 51.2±13.2 岁）773 例破裂动脉瘤患者。治疗医生判断的闭塞率为完全闭塞 586 例（75.8%）、瘤颈残留 145 例（18.8%）、动脉瘤残留 42 例（5.4%）。2 位独立评估者的报告结果与之相同，即完全闭塞 366 例（47.4%）、瘤颈残留 324 例（41.9%）、动脉瘤残留 83 例（10.7%）。术后解剖学结果与年龄显著相关，但与血管内治疗技术或动脉瘤特征（位置、大小、瘤颈比）无关。GDC 组和 Matrix 组之间的结果无显著差异。
结论
血管内治疗破裂颅内动脉瘤可获得较高的满意闭塞率（完全闭塞和瘤颈残留率为 89.3%）。患者年龄是与闭塞率相关的唯一因素。GDC 组和 Matrix 组之间的动脉瘤闭塞率无显著差异。
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