Yue Wentao
Department of Interventional Radiology, Xinxiang Center Hospital, Xinxiang, Henan, China.
Interv Neuroradiol. 2011 Dec;17(4):420-4. doi: 10.1177/159101991101700404. Epub 2011 Dec 16.
We report the clinical and angiographic results of endovascular treatment of unruptured intracranial aneurysms. Over a three-year period, 80 unruptured aneurysms in 74 patients were electively treated with endovascular management. One aneurysm was diagnosed during investigations for a second ruptured aneurysm, 54 aneurysms were incidentally discovered, 18 aneurysms presented with symptoms of mass effect and seven aneurysms presented with symptoms of brain stem ischemia. Mean size of the 80 unruptured aneurysms was 12.5±8.0 mm (range, 2-39 mm). Thirty-six aneurysms (45%) were small (<10 mm), 38 aneurysms (47.5%) were large (10-25 mm), and six aneurysms (7.5%) were giant (25-39 mm). Forty-eight wide-necked aneurysms (60%) were coiled with the aid of a supporting device. The mortality rate was 1.25%, and the overall morbidity was 1.25%. Of these, one of the patients suffered a stroke, leading to severe disability (1.25%). In one patient, the aneurysm ruptured during treatment, resulting in death. Initial aneurysm occlusion was complete (100%) in 76.25% aneurysms, nearly complete (90%-98%) in 10% aneurysms and incomplete (60%-85%) in 13.75% aneurysms. Follow-up angiography was available in 67 patients with 73 treated aneurysms (91.25%) from one to 36 months (mean 9.3 months); partial reopening occurred in 7.5%, mainly large and giant aneurysms (5.5%). Additional coiling was performed in four aneurysms. There were no complications in additional treatments. At 14.1-month clinical follow-up (range, 2 to 36 months), mRS score was 0 in 78.75% patients, 1 in 10% patients, 2 in 8.75% and 3 in 1.25%. There was no aneurysmal rupture during the follow-up period. Endovascular treatment of unruptured intracranial aneurysms has low procedural mortality and morbidity rates.
我们报告了未破裂颅内动脉瘤血管内治疗的临床和血管造影结果。在三年期间，对74例患者的80个未破裂动脉瘤进行了选择性血管内治疗。1个动脉瘤在另一个破裂动脉瘤的检查过程中被诊断出，54个动脉瘤是偶然发现的，18个动脉瘤表现为占位效应症状，7个动脉瘤表现为脑干缺血症状。80个未破裂动脉瘤的平均大小为12.5±8.0毫米（范围为2 - 39毫米）。36个动脉瘤（45%）为小型（<10毫米），38个动脉瘤（47.5%）为大型（10 - 25毫米），6个动脉瘤（7.5%）为巨型（25 - 39毫米）。48个宽颈动脉瘤（60%）借助支撑装置进行了弹簧圈栓塞。死亡率为1.25%，总体发病率为1.25%。其中，1例患者发生中风，导致严重残疾（1.25%）。1例患者在治疗期间动脉瘤破裂，导致死亡。76.25%的动脉瘤初始动脉瘤闭塞完全（100%），10%的动脉瘤接近完全（90% - 98%），13.75%的动脉瘤不完全（60% - 85%）。67例患者的73个治疗动脉瘤（91.25%）进行了1至36个月（平均9.3个月）的随访血管造影；7.5%出现部分再通，主要是大型和巨型动脉瘤（5.5%）。4个动脉瘤进行了额外的弹簧圈栓塞。额外治疗无并发症。在14.1个月的临床随访（范围为2至36个月）中，改良Rankin量表（mRS）评分为0的患者占78.75%，评分为1的患者占10%，评分为2的患者占8.75%，评分为3的患者占1.25%。随访期间无动脉瘤破裂。未破裂颅内动脉瘤的血管内治疗具有较低的手术死亡率和发病率。
