Yamao Yukihiro, Satow Tetsu, Murao Kenichi, Miyamoto Susumu, Iihara Koji
Department of Neurosurgery, Kyoto University, Japan.
No Shinkei Geka. 2012 Jan;40(1):23-9.
Postoperative courses in "coil-protruded" cases in embolization of unruptured cerebral aneurysms remain unknown. The purpose of this study is to investigate postoperative complications after coil protrusions.
From May 2003 to December 2007, 90 consecutive cases with unruptured cerebral aneurysm treated by coil embolization were examined at National Cerebral and Cardiovascular Center. All patients received antiplatelet therapy prior to the procedure. The patterns of protrusions were classified into three; tail (T), loop (L), unraveled (U).
Coil protrusions were observed in 17 cases (18.9%). Symptomatic ischemic complications occurred in 7 cases (7.8%). One case occurred in coil protrusions (group P) and 6 cases occurred in no coil protrusions (group N). Infarctions on MR diffusion-weighted image within 7 days after embolization were found in 10 cases (58.8%) in group P and in 28 cases (38.4%) in group N. Infarction on MR fluid attenuated inversion recovery 7 days or later were found in 0 in group P, and in 4 (5.5%) in group N. There were no significant differences. The number of each protrusion pattern was as follows: T was 12 cases, L was 3 cases and U was 2 cases. Symptomatic ischemia was observed in one case (8.3%) in T. Infarctions on MR diffusion-weighted image within 7 days after embolization were found in 7 (58.3%), 1 (33.3%) and 2 (100%), respectively. There were no significant differences between the three morphological patterns.
In this retrospective study, coil protrusion after embolization of unruptured cerebral aneurysms on antiplatelet therapy, did not increase the incidence of ischemic complications.
未破裂脑动脉瘤栓塞术中“弹簧圈突出”病例的术后病程尚不清楚。本研究旨在调查弹簧圈突出后的术后并发症。
2003年5月至2007年12月，在国立脑与心血管中心对90例连续接受弹簧圈栓塞治疗的未破裂脑动脉瘤病例进行了检查。所有患者在手术前均接受抗血小板治疗。突出模式分为三种：尾状（T）、环状（L）、松散状（U）。
观察到17例（18.9%）弹簧圈突出。7例（7.8%）出现有症状的缺血性并发症。1例发生在弹簧圈突出组（P组），6例发生在无弹簧圈突出组（N组）。栓塞后7天内，P组10例（58.8%）在磁共振扩散加权成像上发现梗死，N组28例（38.4%）发现梗死。P组在磁共振液体衰减反转恢复序列上7天或更晚发现梗死的为0例，N组为4例（5.5%）。无显著差异。每种突出模式的数量如下：T型12例，L型3例，U型2例。T型中有1例（8.3%）出现有症状的缺血。栓塞后7天内，磁共振扩散加权成像上发现梗死的分别为7例（58.3%）、1例（33.3%）和2例（100%）。三种形态模式之间无显著差异。
在这项回顾性研究中，接受抗血小板治疗的未破裂脑动脉瘤栓塞术后的弹簧圈突出并未增加缺血性并发症的发生率。
