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覆膜支架与线圈栓塞治疗颅内颈内动脉动脉瘤的对比研究:一项非随机前瞻性试验。

Comparative study of covered stent with coil embolization in the treatment of cranial internal carotid artery aneurysm: a nonrandomized prospective trial.

机构信息

Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, 200233, China.

出版信息

Eur Radiol. 2010 Nov;20(11):2732-9. doi: 10.1007/s00330-010-1854-z. Epub 2010 Aug 11.

Abstract

To evaluate whether Willis covered stent implantation yielded angiographic and clinical results were better than those with coil embolization. Eighty-nine patients with cranial internal carotid artery (CICA) aneurysms were treated nonrandomly with covered stents (n = 43, group A) or coil embolization (n = 46, group B). Data on the technical success, procedure time, initial and final angiographic results, and final clinical outcomes were collected and analyzed at >6 months post-procedure. Covered stent placement and coil embolization were successful in all patients, except for one patient in group A. The initial angiographic results showed complete occlusion in 34 group-A patients (80.9%; 95% CI: 69%, 93%) and 24 group-B patients (52.2%; 95% CI: 37%, 67%) (P = 0.004). The final angiographic results indicated complete occlusion in 39 group A patients (39/41, 95.1%; 95% CI: 88%, 102%) and 22 group B patients (48.9%; 95% CI: 34%, 64%) (P < 0.001). The average procedure time was shorter in group A than that in group B (P < 0.001). CICA aneurysm treatment with covered stents yielded better intermediate-term angiographic outcome than those with the recommended approach of coil embolization. (ClinicalTrials.gov number, NCT01029938).

摘要

评估 Willis 覆膜支架植入术的血管造影和临床结果是否优于线圈栓塞术。89 例颅内颈内动脉(CICA)动脉瘤患者被非随机地采用覆膜支架(n = 43,A 组)或线圈栓塞(n = 46,B 组)治疗。收集并分析了>6 个月后患者的技术成功率、手术时间、初始和最终血管造影结果以及最终临床结果。除了 A 组的 1 名患者外,覆膜支架置入和线圈栓塞术在所有患者中均成功。初始血管造影结果显示,A 组 34 例患者(80.9%;95%可信区间:69%,93%)和 B 组 24 例患者(52.2%;95%可信区间:37%,67%)完全闭塞(P = 0.004)。最终血管造影结果显示,A 组 39 例患者(39/41,95.1%;95%可信区间:88%,102%)和 B 组 22 例患者(48.9%;95%可信区间:34%,64%)完全闭塞(P < 0.001)。A 组的平均手术时间短于 B 组(P < 0.001)。覆膜支架治疗 CICA 动脉瘤的中期血管造影结果优于推荐的线圈栓塞术。(临床试验注册号:NCT01029938)。

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