Payner Troy D, Melamed Itay, Ansari Shaheryar, Leipzig Thomas J, Scott John A, Denardo Andrew J, Horner Terry G, Redelman Kathleen, Cohen-Gadol Aaron A
Department of Neurological Surgery, Goodman Campbell Brain and Spine, Indiana University, Indianapolis, IN, USA.
Surg Neurol Int. 2011;2:110. doi: 10.4103/2152-7806.83728. Epub 2011 Aug 13.
To better understand the longitudinal trend in the proportion of techniques employed for cerebral aneurysm treatment, we reviewed our experience with 2253 patients over the last 11 years.
We reviewed data in our prospective aneurysm database for all consecutive patients treated from January 1998 through December 2009. Data regarding age, sex, aneurysm location, presence or absence of hemorrhage, Fisher grade, clinical grade, treatment methods, length of hospitalization, and mortality rates by the time of discharge were retrieved and retrospectively analyzed. The most common aneurysm types were subsequently classified and analyzed separately.
The patient population included 663 males (29%) and 1590 females (71%). A total of 2253 patients presented with 3413 aneurysms; 1523 (63%) of the aneurysms were diagnosed as aneurysmal subarachnoid hemorrhage. A total of 2411 (71%) aneurysms were treated. Overall, 645 (27%) of the 2411 aneurysms underwent endosaccular coiling and 1766 (73%) underwent clip ligation; 69 (3%) of these aneurysms required both treatment modalities. The percentage of all aneurysms treated by endosaccular coiling increased from 8% (21) in 1998 to 28% (87) in 2009. There was no statistical difference between the average length of hospitalization for patients who underwent endosaccular coiling and clip ligation for their ruptured (P = 0.19) and unruptured (P = 0.80) aneurysms during this time period.
In our practice, endovascular treatment has continued to be more frequently employed to treat cerebral aneurysms. This technique has had the greatest proportional increase in the treatment of posterior circulation aneurysms.
为了更好地了解脑动脉瘤治疗技术应用比例的纵向趋势，我们回顾了过去11年中2253例患者的治疗经验。
我们回顾了前瞻性动脉瘤数据库中1998年1月至2009年12月期间所有连续治疗患者的数据。收集了患者的年龄、性别、动脉瘤位置、是否出血、Fisher分级、临床分级、治疗方法、住院时间和出院时的死亡率等数据，并进行回顾性分析。随后对最常见的动脉瘤类型进行分类并分别分析。
患者群体包括663名男性（29%）和1590名女性（71%）。共有2253例患者出现3413个动脉瘤；其中1523个（63%）动脉瘤被诊断为动脉瘤性蛛网膜下腔出血。总共治疗了2411个（71%）动脉瘤。总体而言，2411个动脉瘤中有645个（27%）接受了囊内栓塞，1766个（73%）接受了夹闭术；其中69个（3%）动脉瘤需要两种治疗方式。囊内栓塞治疗的所有动脉瘤百分比从1998年的8%（21个）增加到2009年的28%（87个）。在此期间，因破裂（P = 0.19）和未破裂（P = 0.80）动脉瘤接受囊内栓塞和夹闭术的患者平均住院时间无统计学差异。
在我们的实践中，血管内治疗继续更频繁地用于治疗脑动脉瘤。该技术在后循环动脉瘤治疗中的应用比例增加最大。
