Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 lrwon-dong, Gangnam-gu, Seoul, 135-710, South Korea.
Acta Neurochir (Wien). 2013 Jun;155(6):1101-6. doi: 10.1007/s00701-013-1706-0. Epub 2013 Apr 27.
To identify the incidence of thromboembolic complications based on magnetic resonance imaging (MRI) and to explore the potential risk factors for thromboembolism (TE) during the periprocedural period of elective coil embolization for unruptured intracranial aneurysms.
We retrospectively reviewed all aneurysm cases treated with coil insertion between January 2008 and March 2011. Two hundred eighty-two coiling procedures for unruptured aneurysms were included in this study. The patients' demographic characteristics were documented and records reviewed for abnormalities in diffusion-weighted imaging (DWI) seen on post-procedure MRI, intraoperative thrombus formation, and clinical signs of stroke.
Overall, there were 87 (30.9 %) procedure-related complications in 282 aneurysms treated: 2 (0.7 %) procedural ruptures, 5 (1.8 %) symptomatic infarctions, and 80 (28.3 %) asymptomatic infarctions. Thromboembolic events during the procedure were observed more often in the the hyperlipidemia group (32/71 aneurysms, 45.1 %) than in the normal lipid profile group (39/196 aneurysms, 25.6 %; p = 0.002; chi-squre test). The coiling technique and size of the aneurysm were also associated with TE (p < 0.001 and p = 0.004).
Hyperlipidemia seems to be associated with a significant increase in the rate of thromboembolic events. In preventive procedures, modifiable risk factors should be managed to reduce complications. Although permanent deficits are rare, the high rate of thromboembolic events suggests that improvements in the technique, such as the addition of antiplatelet agents and the development of new embolic materials, are necessary.
通过磁共振成像（MRI）确定血栓栓塞并发症的发生率，并探讨择期颅内未破裂动脉瘤弹簧圈栓塞围手术期血栓形成的潜在危险因素。
我们回顾性分析了 2008 年 1 月至 2011 年 3 月期间采用弹簧圈插入术治疗的所有动脉瘤病例。本研究共纳入 282 例未破裂动脉瘤的弹簧圈栓塞术。记录患者的人口统计学特征，并对术后 MRI 显示的弥散加权成像（DWI）异常、术中血栓形成和中风的临床症状进行回顾。
282 个动脉瘤中共有 87 个（30.9%）与操作相关的并发症：2 个（0.7%）操作破裂，5 个（1.8%）症状性梗死，80 个（28.3%）无症状性梗死。在高脂血症组（32/71 个动脉瘤，45.1%）中，术中血栓栓塞事件比正常血脂组（39/196 个动脉瘤，25.6%；p=0.002；卡方检验）更常见。弹簧圈技术和动脉瘤大小也与 TE 相关（p<0.001 和 p=0.004）。
高脂血症似乎与血栓栓塞事件发生率显著增加有关。在预防性手术中，应管理可改变的危险因素以减少并发症。尽管永久性缺损罕见，但血栓栓塞事件发生率较高，表明需要改进技术，如添加抗血小板药物和开发新的栓塞材料。
