单中心应用双微导管技术血管内治疗宽颈动脉瘤的经验
Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms.
作者信息
Durst Christopher R, Starke Robert M, Gaughen John R, Geraghty Scott, Kreitel K Derek, Medel Ricky, Demartini Nicholas, Liu Kenneth C, Jensen Mary E, Evans Avery J
机构信息
Departments of Radiology and Medical Imaging and.
出版信息
J Neurosurg. 2014 Nov;121(5):1093-101. doi: 10.3171/2014.7.JNS132237. Epub 2014 Aug 22.
OBJECT
The endovascular treatment of wide-necked aneurysms can be technically challenging due to distal coil migration or impingement of the parent vessel. In this paper, the authors illustrate an alternative method for the treatment of wide-necked intracranial aneurysms using a dual microcatheter technique.
METHODS
The authors' first 100 consecutive patients who underwent coil embolization of a wide-necked aneurysm using a dual microcatheter technique are reported. With this technique, 2 microcatheters are used to introduce coils into the aneurysm. The coils are deployed either sequentially or concurrently to form a stable construct and prevent coil herniation or migration. Angiographic and clinical outcomes are reported.
RESULTS
The technical success rate of the dual microcatheter technique is 91% with a morbidity and mortality of 1% and 2%, respectively. Clinical outcomes are excellent with 93% of patients demonstrating a modified Rankin Scale score of 0-2 at long-term follow-up regardless of their score at presentation. Retreatment rates are 18%.
CONCLUSIONS
The dual microcatheter technique may be a safe and efficacious first line of treatment for widenecked aneurysms.
目的
由于弹簧圈向远端移位或母血管受挤压，宽颈动脉瘤的血管内治疗在技术上可能具有挑战性。在本文中，作者阐述了一种使用双微导管技术治疗颅内宽颈动脉瘤的替代方法。
方法
报告了作者连续收治的首批100例使用双微导管技术对宽颈动脉瘤进行弹簧圈栓塞的患者。采用该技术时，使用2根微导管将弹簧圈引入动脉瘤。弹簧圈可顺序或同时释放，以形成稳定结构并防止弹簧圈疝出或移位。报告了血管造影和临床结果。
结果
双微导管技术的技术成功率为91%，发病率和死亡率分别为1%和2%。临床结果良好，93%的患者在长期随访中改良Rankin量表评分为0 - 2分，无论其就诊时的评分如何。再治疗率为18%。
结论
双微导管技术可能是治疗宽颈动脉瘤的一种安全有效的一线治疗方法。
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