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支架辅助线圈固定技术有助于高效栓塞微小脑动脉瘤。

The stent-assisted coil-jailing technique facilitates efficient embolization of tiny cerebral aneurysms.

机构信息

Department of Neurosurgery, Shijiazhuang First Hospital, Hebei Medical University, Shijiazhuang 050011, China.

出版信息

Korean J Radiol. 2014 Nov-Dec;15(6):850-7. doi: 10.3348/kjr.2014.15.6.850. Epub 2014 Nov 7.

Abstract

OBJECTIVE

Tiny cerebral aneurysms are difficult to embolize because the aneurysm's sac is too small for a single small coil, and coils within the aneurysm may escape from the confinement of a stent. This study was performed to introduce the stent-assisted coil-jailing technique and to investigate its effect on the coil embolization of tiny intracranial aneurysms.

MATERIALS AND METHODS

Sixteen patients with tiny intracranial aneurysms treated with the stent-assisted coil-jailing technique between January 2011 and December 2013 were retrospectively reviewed and followed-up.

RESULTS

All aneurysms were successfully treated with the coil-jailing technique, and at the end of embolization, complete occlusion of the aneurysm was achieved in 9 cases (56.3%), incomplete occlusion in 6 (37.5%), and partial occlusion in 1 (6.3%). Intraprocedural complications included acute thrombosis in one case (6.3%) and re-rupture in another (6.3%). Both complications were managed appropriately with no sequela. Follow-up was performed in all patients for 3-24 months (mean, 7.7 months) after embolization. Complete occlusion was sustained in the 9 aneurysms with initial complete occlusion, progressive thrombosis to complete occlusion occurred in the 6 aneurysms with initial near-complete occlusion, and one aneurysm resulted in progressive thrombosis to complete occlusion after initial partial occlusion. No migration of stents or coils occurred at follow-up as compared with their positions immediately after embolization. At follow-up, all patients had recovered with no sequela.

CONCLUSION

The stent-assisted coil-jailing technique can be an efficient approach for tiny intracranial aneurysms, even though no definite conclusion regarding its safety can be drawn from the current data.

摘要

目的

微小脑动脉瘤由于瘤囊太小,无法容纳单个小线圈,且瘤内线圈可能会从支架的限制中逃脱,因此难以栓塞。本研究旨在介绍支架辅助线圈套圈技术,并探讨其在微小颅内动脉瘤线圈栓塞中的效果。

材料与方法

回顾性分析 2011 年 1 月至 2013 年 12 月采用支架辅助线圈套圈技术治疗的 16 例微小颅内动脉瘤患者,并对其进行随访。

结果

所有动脉瘤均成功采用线圈套圈技术治疗,在栓塞结束时,9 例(56.3%)完全闭塞,6 例(37.5%)不完全闭塞,1 例(6.3%)部分闭塞。术中并发症包括 1 例(6.3%)急性血栓形成和另 1 例(6.3%)再破裂。均通过适当的处理,无后遗症。栓塞后所有患者均进行了 3-24 个月(平均 7.7 个月)的随访。9 例初始完全闭塞的动脉瘤中,有 9 例保持完全闭塞;6 例初始近完全闭塞的动脉瘤中,进展性血栓形成至完全闭塞;1 例初始部分闭塞的动脉瘤进展性血栓形成至完全闭塞。与栓塞后即刻相比,支架和线圈在随访时均无移位。随访时,所有患者均恢复良好,无后遗症。

结论

支架辅助线圈套圈技术对于微小颅内动脉瘤是一种有效的方法,但目前的数据尚不能得出其安全性的明确结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e291/4248643/12c0424541b4/kjr-15-850-g001.jpg

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