Lee D H, Arat A, Morsi H, Diaz O, Jou L D, Mawad M E
Department of Radiology, St. Luke's Episcopal Hospital, Baylor College of Medicine, USA - Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, USA -
Interv Neuroradiol. 2007 Sep;13(3):239-46. doi: 10.1177/159101990701300303. Epub 2007 Sep 15.
Little attention has been given to the intimal thickening of the parent artery associated with the use of Neuroform stent. The purposes of this study were are to analyze quantifyanalyze the incidence of the parent artery intimal thickening the incidence and pattern of luminal changes, to to see somedetermine possible predictors of the phenomenonof the intimal thickening, to to evaluate the its effectthe phenomenonrestenosis on the aneurysm treatment results. We reviewed the initial and six-month followup angiographic images in 32 intracranial aneurysm patients treated with Neuroform stent and coilsin wide-necked aneurysm treatment. The initial embolization results were evaluated by the Raymond and Roy classification. The angiographic changes from immediate post-embolization to the six-month follow-up were classified as 'improved', 'unchanged' and 'worse'. The occurrencerates of parent artery intimal thickening was observed. Any perceivable change in the stented segment of the parent artery was considered as 'intimal thickening' and any change of >/=50% as 'significant thickening'. Fisher exact tests and logistic regression analysis were applied to determine the relation between the occurrence of the intimal thickening and several variables. The incidence of the intimal thickening was 18.8% (6/32) and of significant thickening, 3.1% (1/32). The change in angiographic occlusion of the aneurysm was 'improved' in 40.6% (13/32), 'unchanged' in 37.5% (12/32), and 'worse' in 21.9% (7/32). Among the variables, patient's age (>/=55) and follow-up angiographic results ('improved') correlated with the occurrence of the intimal thickening. Of notable finding was all six cases with intimal thickening of the parent artery were associated with 'improved' in their followup angiographic result. Neuroform-associated intimal thickening usually occurs in younger patients and is frequently associated with improved angiographic result of the aneurysm embolization on follow-up.
与使用Neuroform支架相关的载瘤动脉内膜增厚很少受到关注。本研究的目的是分析载瘤动脉内膜增厚的发生率和管腔变化的模式，确定内膜增厚现象的可能预测因素，评估其对动脉瘤治疗结果的影响。我们回顾了32例接受Neuroform支架和弹簧圈治疗的颅内动脉瘤患者（用于宽颈动脉瘤治疗）的初始和6个月随访血管造影图像。初始栓塞结果采用Raymond和Roy分类法进行评估。从栓塞后即刻到6个月随访的血管造影变化分为“改善”、“不变”和“恶化”。观察载瘤动脉内膜增厚的发生率。载瘤动脉支架段的任何可察觉变化被视为“内膜增厚”，任何≥50%的变化被视为“显著增厚”。应用Fisher精确检验和逻辑回归分析来确定内膜增厚的发生与几个变量之间的关系。内膜增厚的发生率为18.8%（6/32），显著增厚的发生率为3.1%（1/32）。动脉瘤血管造影闭塞情况的变化为“改善”的占40.6%（13/32），“不变”的占37.5%（12/32），以及“恶化”的占21.9%（7/32）。在这些变量中，患者年龄（≥55岁）和随访血管造影结果（“改善”）与内膜增厚的发生相关。值得注意的发现是，载瘤动脉内膜增厚的所有6例患者在随访血管造影结果中均为“改善”。与Neuroform相关的内膜增厚通常发生在年轻患者中，并且在随访中经常与动脉瘤栓塞的血管造影结果改善相关。
