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Neuroform 支架辅助弹簧圈栓塞治疗宽颈颅内动脉瘤及临床因素对血管造影随访中动脉瘤渐进性闭塞的影响。

The effect of Neuroform stent-assisted coil embolization of wide-necked intracranial aneurysms and clinical factors on progressive aneurysm occlusion on angiographic follow-up.

机构信息

Department of Neurosurgery, Southern Medical University, Zhujiang Hospital, 253 Industry Road, 510282 Guangzhou, Guangdong, China.

出版信息

J Clin Neurosci. 2013 Feb;20(2):244-7. doi: 10.1016/j.jocn.2012.01.053. Epub 2012 Nov 30.

Abstract

Stent-assisted coil embolization is an endovascular treatment for wide-necked intracranial aneurysms, but the durability of this treatment is not well known. The aim of this study is to investigate the effect of the Neuroform stent (Boston Scientific/Target, Fremont, CA, USA) in progressive occlusion of wide-necked intracranial aneurysms, and to assess any correlation between clinical factors and angiographic follow-up results. The records of 52 patients treated with a Neuroform stent were retrieved for analysis of population characteristics, initial and follow-up angiographic results, and clinical outcomes. Initial angiographic results showed complete occlusion in 21 (40.4%), neck remnants in 22 (42.3%), and residual aneurysms in nine (17.3%). Angiographic follow-up was available in 45 of 52 (86.5%) patients: complete occlusion was achieved in 32 (71.1%), neck remnants were present in eight (17.8%) and residual aneurysms in five (11.1%). Of 31 patients with immediate incomplete obliteration, progressive complete occlusion was achieved in 16 of 28 (57.1%) patients. Clinical follow-up showed good outcomes according to the modified Rankin Scale score. A univariate analysis showed that there was no effect of the tested clinical variables of patient age (p=0.823), gender (p=0.419), aneurysm location (p=0.394), size (p=0.625) and rupture status (p=0.721) on aneurysm occlusion at follow-up. We conclude that the Neuroform stent-assisted neck remodelling technique improves progressive occlusion of wide-necked intracranial aneurysms with good clinical outcomes.

摘要

支架辅助弹簧圈栓塞是一种治疗宽颈颅内动脉瘤的血管内治疗方法,但这种治疗的耐久性尚不清楚。本研究旨在探讨 Neuroform 支架(波士顿科学/Target,弗里蒙特,加利福尼亚州,美国)在宽颈颅内动脉瘤进行性闭塞中的作用,并评估临床因素与血管造影随访结果之间的任何相关性。回顾性分析了 52 例接受 Neuroform 支架治疗的患者的记录,以分析人口统计学特征、初始和随访血管造影结果以及临床结果。初始血管造影结果显示完全闭塞 21 例(40.4%),颈部残留 22 例(42.3%),残余动脉瘤 9 例(17.3%)。在 52 例患者中有 45 例(86.5%)进行了血管造影随访:完全闭塞 32 例(71.1%),颈部残留 8 例(17.8%),残余动脉瘤 5 例(11.1%)。在 31 例即时不完全闭塞的患者中,28 例中有 16 例(57.1%)患者进行了渐进性完全闭塞。临床随访显示改良 Rankin 量表评分良好。单因素分析显示,患者年龄(p=0.823)、性别(p=0.419)、动脉瘤位置(p=0.394)、大小(p=0.625)和破裂状态(p=0.721)等测试的临床变量对随访时的动脉瘤闭塞无影响。我们得出结论,Neuroform 支架辅助血管重塑技术可改善宽颈颅内动脉瘤的进行性闭塞,且具有良好的临床效果。

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