Park Hyun Seok, Kwon Soon Chan, Shin Shang Hoon, Park Eun Suk, Sim Hong Bo, Lyo In Uk
Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Neurointervention. 2013 Sep;8(2):73-9. doi: 10.5469/neuroint.2013.8.2.73. Epub 2013 Aug 29.
This study is an overview of the clinical and radiologic outcomes of endovascular coil embolization for cerebral aneurysm in patients aged 40 years and younger.
Between January 2008 and June 2011, 218 aneurysms were treated using endovascular coil embolization and followed up with cerebral angiography at least six months later. Twenty-one aneurysms occurred in patients aged 40 years and younger, while 197 occurred in 179 patients older than 40 years. The clinical and radiologic results were retrospectively analyzed and compared between the two groups using the modified Rankin scale scores and the modified Raymond scale.
Follow-up cerebral angiography revealed two (9.5%) major and two (9.5%) minor recanalized aneurysms in patients aged 40 years and younger, and six (3.0%) major and 35 (17.7%) minor recanalized aneurysms in patients older than 40 years. However, the differences between the groups were not statistically significant. The preoperative and postoperative mean modified Rankin scale scores at time for follow-up angiography were 1.14 and 0.19 respectively for patients aged 40 years and younger, and 1.30 and 0.30 respectively for patients older than 40 years.
The younger patients had clinically favorable outcomes with tolerable angiographic follow-up results. More regular and long-term imaging follow-up is required for younger patients due to their longer life expectancy.
本研究是对40岁及以下患者脑动脉瘤血管内弹簧圈栓塞术的临床和放射学结果的概述。
2008年1月至2011年6月期间,对218个动脉瘤进行了血管内弹簧圈栓塞治疗,并在至少6个月后进行脑血管造影随访。40岁及以下患者发生21个动脉瘤,而179例40岁以上患者发生197个动脉瘤。使用改良Rankin量表评分和改良Raymond量表对两组的临床和放射学结果进行回顾性分析和比较。
随访脑血管造影显示,40岁及以下患者中有2个(9.5%)主要和2个(9.5%)次要再通动脉瘤,40岁以上患者中有6个(3.0%)主要和35个(17.7%)次要再通动脉瘤。然而,两组之间的差异无统计学意义。40岁及以下患者在随访血管造影时术前和术后平均改良Rankin量表评分分别为1.14和0.19,40岁以上患者分别为1.30和0.30。
年轻患者临床预后良好,血管造影随访结果可接受。由于年轻患者预期寿命较长,因此需要更定期和长期的影像学随访。