Kai Y, Hamada J, Morioka M, Yano S, Kuratsu J
Department of Neurosurgery, Graduate School of Medical Science, Kumamoto University; Kumamoto, Japan -
Interv Neuroradiol. 2006 Jan 20;12(Suppl 1):91-6. doi: 10.1177/15910199060120S113. Epub 2006 Jun 15.
It is difficult to predict the compaction of Guglielmi detachable coils (GDC) after endovascular surgery for aneurysms. Therefore, we studied the relationship between the coil packing ratio and compaction in 62 patients with acute ruptured intracranial aneurysms that were small (< 10 mm) had a small neck (< 4 mm) and were coil-embolized with GDC-10. We recorded the maximum prospective coil length, L, as the length that correspond with the volume of packed coils occupying 30% of the aneurysmal volume. L was calculated as L (cm) = 0.3 x a x b x c and the coil packing ratio expressed as packed coil length/L x 100, where a, b, and c are the aneurysmal height, length, and width in mm, respectively. Angiographic followup studies were performed at three months and one and two years after endovascular surgery. Of the 62 patients, 16 (25.8%) manifested angiographic coil compaction (ten minor and six major compactions); the mean coil packing ratio was 51.9 +/- 13.4%. The mean coil packing ratio in the other 46 patients was 80.5 +/- 20.2% and the difference was statistically significant (p < 0.01). In all six patients with major compaction the mean packing ratio was below 50%. We detected 93.8% of the compactions within 24 months of coil placement. In patients with small, necked aneurysms, the optimal coil packing ratio could be identified with the formula 0.3 x a x b x c. The probability of compaction was significantly higher when the coil packing ratio was under 50%. To detect coil compaction post-embolization, follow-up angiograms must be examined regularly for at least 24 months.
对于动脉瘤的血管内手术后 Guglielmi 可脱卸弹簧圈（GDC）的致密化情况很难进行预测。因此，我们研究了 62 例急性破裂颅内动脉瘤患者的弹簧圈填充率与致密化之间的关系，这些动脉瘤较小（<10mm）、颈部较小（<4mm）且使用 GDC-10 进行弹簧圈栓塞。我们记录了最大预期弹簧圈长度 L，即与占据动脉瘤体积 30%的填充弹簧圈体积相对应的长度。L 的计算方法为 L（cm）=0.3×a×b×c，其中 a、b、c 分别为动脉瘤的高度、长度和宽度（单位为 mm），弹簧圈填充率表示为填充弹簧圈长度/L×100。在血管内手术后 3 个月、1 年和 2 年进行血管造影随访研究。62 例患者中，16 例（25.8%）出现血管造影弹簧圈致密化（10 例轻度和 6 例重度致密化）；平均弹簧圈填充率为 51.9±13.4%。其他 46 例患者的平均弹簧圈填充率为 80.5±20.2%，差异具有统计学意义（p<0.01）。在所有 6 例重度致密化患者中，平均填充率均低于 50%。我们在弹簧圈置入后 24 个月内检测到了 93.8%的致密化情况。对于小型有颈部的动脉瘤患者，可通过公式 0.3×a×b×c 确定最佳弹簧圈填充率。当弹簧圈填充率低于 50%时，致密化的概率显著更高。为了检测栓塞后弹簧圈致密化情况，必须定期检查随访血管造影至少 24 个月。
