Jindal Gaurav, Miller Timothy, Beaty Narlin, Puri Ajit, Gandhi Dheeraj
Department of Radiology, University of Maryland Medical Center, Baltimore, USA
Department of Radiology, University of Maryland Medical Center, Baltimore, USA.
Interv Neuroradiol. 2015 Feb;21(1):50-4. doi: 10.15274/inr-2014-10105.
This study reports our initial clinical experience treating very small intracranial aneurysms using only Target® Nano™ coils. Retrospective angiographic and clinical analysis was performed on a non-randomized single arm registry of all intracranial aneurysms treated with only Target® Nano™ coils (1 mm and 1.5 mm diameter only) during a 12 month period at two academic hospitals. Fourteen patients with 14 intracranial aneurysms were treated. The maximum diameter of saccular aneurysms treated ranged from 1.5 to 3.5 mm; minimum aneurysm diameter was 1.1 to 2 mm. The immediate complete aneurysm occlusion rate was 86% (12/14), and a small residual within the aneurysm was seen in 14% (2/14) of cases. Packing density from coils ranged between 24% and 83% (mean 51%). The immediate complication rate was 0% (0/14). The angiographic/MR angiography follow-up period was 22 to 70 weeks (mean 37 weeks) with an overall complete occlusion rate of 9/11 (81%), recurrence in 18% (2/11), and lack of follow-up in three cases, two due to death during hospitalization and one procedure not yet due for imaging follow-up. Both patients who died presented with brain aneurysm ruptures prior to treatment. Both recurrences were retreated with repeat coiling procedures. Our initial results using only Target® Nano™ coils for the endovascular treatment of very small intracranial aneurysms have demonstrated initial good safety and efficacy profiles.
本研究报告了我们仅使用Target® Nano™ 弹簧圈治疗非常小的颅内动脉瘤的初步临床经验。对两家学术医院在12个月期间仅使用Target® Nano™ 弹簧圈（仅直径1毫米和1.5毫米）治疗的所有颅内动脉瘤的非随机单臂登记进行回顾性血管造影和临床分析。治疗了14例患有14个颅内动脉瘤的患者。治疗的囊状动脉瘤最大直径为1.5至3.5毫米；最小动脉瘤直径为1.1至2毫米。即刻动脉瘤完全闭塞率为86%（12/14），14%（2/14）的病例在动脉瘤内可见小的残余。弹簧圈的填充密度在24%至83%之间（平均51%）。即刻并发症发生率为0%（0/14）。血管造影/磁共振血管造影随访期为22至70周（平均37周），总体完全闭塞率为9/11（81%），复发率为18%（2/11），3例未进行随访，2例因住院期间死亡，1例手术尚未到影像学随访时间。两名死亡患者在治疗前均出现脑动脉瘤破裂。两次复发均通过重复弹簧圈置入术进行了再次治疗。我们仅使用Target® Nano™ 弹簧圈对非常小的颅内动脉瘤进行血管内治疗的初步结果已显示出初步良好的安全性和有效性。
