Jindal Gaurav, Miller Timothy, Iyohe Moronke, Shivashankar Ravi, Prasad Vikram, Gandhi Dheeraj
Department of Interventional Neuroradiology, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA.
J Vasc Interv Neurol. 2016 Jun;9(1):46-51.
The introduction of small, soft, complex-shaped microcoils has helped facilitate the endovascular treatment of small intracranial aneurysms (IAs) over the last several years. Here, we evaluate the initial safety and efficacy of treating small IAs using only Target(®) Ultrasoft(™) coils.
A retrospective review of a prospectively maintained clinical database at a single, high volume, teaching hospital was performed from September 2011 to May 2015. IAs smaller than or equal to 5.0 mm in maximal dimension treated with only Target(®) Ultrasoft(™) coils were included.
A total of 50 patients with 50 intracranial aneurysms were included. Subarachnoid hemorrhage from index aneurysm rupture was the indication for treatment in 23 of 50 (46%) cases, and prior subarachnoid hemorrhage (SAH) from another aneurysm was the indication for treatment in eight of 50 (16%) cases. The complete aneurysm occlusion rate was 70% (35/50), the minimal residual aneurysm rate was 14% (7/50), and residual aneurysm rate was 16% (8/50). One intraoperative aneurysm rupture occurred. Three patients died during hospitalization from clinical sequelae of subarachnoid hemorrhage. Follow-up at a mean of 13.6 months demonstrated complete aneurysm occlusion in 75% (30/40) of cases, near complete occlusion in 15% (6/40) of cases, and residual aneurysm in 10% (4/40) of cases, all four of which were retreated.
Our initial results using only Target(®) Ultrasoft(™) coils for the endovascular treatment of small intracranial aneurysms demonstrate initial excellent safety and efficacy profiles.
在过去几年中,小型、柔软、形状复杂的微线圈的引入有助于推动小型颅内动脉瘤(IA)的血管内治疗。在此,我们评估仅使用Target(®) Ultrasoft(™) 线圈治疗小型IA的初始安全性和有效性。
对一家大型教学医院前瞻性维护的临床数据库进行回顾性分析,时间跨度为2011年9月至2015年5月。纳入仅使用Target(®) Ultrasoft(™) 线圈治疗的最大直径小于或等于5.0毫米的IA。
共纳入50例患有50个颅内动脉瘤的患者。50例中有23例(46%)的治疗指征为索引动脉瘤破裂导致的蛛网膜下腔出血,50例中有8例(16%)的治疗指征为另一个动脉瘤先前的蛛网膜下腔出血(SAH)。动脉瘤完全闭塞率为70%(35/50),最小残余动脉瘤率为14%(7/50),残余动脉瘤率为16%(8/50)。术中发生1例动脉瘤破裂。3例患者因蛛网膜下腔出血的临床后遗症在住院期间死亡。平均13.6个月的随访显示,75%(30/40)的病例动脉瘤完全闭塞,15%(6/40)的病例接近完全闭塞,10%(4/40)的病例有残余动脉瘤,所有4例残余动脉瘤均再次进行了治疗。
我们仅使用Target(®) Ultrasoft(™) 线圈进行小型颅内动脉瘤血管内治疗的初步结果显示出初步良好的安全性和有效性。