Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Radiol. 2010 Sep-Oct;11(5):536-41. doi: 10.3348/kjr.2010.11.5.536. Epub 2010 Aug 27.
We aimed to evaluate the results of endovascular coil embolization for very small aneurysms (<or= 3 mm).
Between March 2005 and December 2008, a total of 31 very small aneurysms in 30 patients were treated by coil embolization. Of the 31 aneurysms, five (16%) were ruptured, as opposed to 26 (84%) that were not. We assessed the procedural complications, immediate angiographic outcome after coiling, clinical outcome, and follow-up MR angiography (MRA).
Two thromboembolic complications occurred during the procedure, but did not lead to any persistent neurologic deficit. No procedural aneurysmal rupture was observed and procedure-related morbidity and mortality were both 0%. Occlusion was adequate in 25 aneurysms (81%) and incomplete in six aneurysms (19%). The clinical outcomes of five patients with ruptured aneurysms were good (Glasgow outcome scale >or= 4), with no bleeding of the treated aneurysms during a mean follow-up period of 13.3 months. On 27 follow-up MRA, there was no recurrence, and the five incompletely occluded aneurysms showed a spontaneous amelioration resulting in an adequate occlusion.
Coil embolization of very small aneurysms is technically feasible with good results. The long-term efficacy and the potential as a standard treatment strategy remain to be determined by randomized large trials.
我们旨在评估血管内线圈栓塞治疗非常小的动脉瘤（<=3 毫米）的结果。
在 2005 年 3 月至 2008 年 12 月期间，共对 30 名患者的 31 个非常小的动脉瘤进行了线圈栓塞治疗。在这 31 个动脉瘤中，有 5 个（16%）是破裂的，而 26 个（84%）是非破裂的。我们评估了手术并发症、线圈栓塞后的即时血管造影结果、临床结果和随访磁共振血管造影（MRA）。
在手术过程中发生了 2 例血栓栓塞并发症，但没有导致任何持续性神经功能缺损。没有观察到与手术相关的动脉瘤破裂，手术相关的发病率和死亡率均为 0%。25 个动脉瘤（81%）的闭塞是充分的，6 个动脉瘤（19%）的闭塞是不完全的。5 例破裂动脉瘤患者的临床结果良好（格拉斯哥预后评分>=4），在平均 13.3 个月的随访期间，治疗的动脉瘤没有出血。在 27 次随访 MRA 中，没有复发，5 个不完全闭塞的动脉瘤自发改善，导致充分闭塞。
线圈栓塞治疗非常小的动脉瘤在技术上是可行的，且结果良好。其长期疗效和作为标准治疗策略的潜力仍有待通过随机大型试验来确定。
