Huang De-Zhang, Jiang Bin, He Wei, Wang Yi-Hua, Wang Zhi-Gang
Department of Neurosurgery, Qilu Hospital of Shandong University, Qingdao 266035, China.
Oncotarget. 2017 May 16;8(20):33676-33682. doi: 10.18632/oncotarget.16897.
This study was aimed to determine risk factors for the recurrence of an intracranial saccular aneurysm (ISA) following endovascular treatment. The findings will help medical professionals to identify patients having a high risk of ISA recurrence and assist them in developing appropriate follow-up plans.
During the follow-up period, 12.6% of the patients (83/658) experienced recurrent ISAs. An analysis of related factors, including gender, age, hypertension, diabetes mellitus, smoking, tumor size, width of the aneurysm neck, the presence or absence of a rupture, the volume embolization ratio (VER), the application or nonapplication of a stent, and follow-up time, revealed that a tumor size > 10 mm in diameter, wide-necked aneurysms, an anterior communicating or middle cerebral artery aneurysm, an aneurysm rupture, a VER < 20%, the absence of stent assistance, and follow-up time were high-risk factors for the recurrence of ISAs.
We retrospectively reviewed the records of 658 patients who underwent endovascular treatment for ISAs from January 2010 through December 2014. Multivariable logistic regression was performed on the candidates' risk factors, which were identified via univariable screening analysis.
Smoking, a large tumor size, a wide-necked aneurysm, an anterior communicating or middle cerebral artery aneurysm, an aneurysm rupture, a VER < 20%, and an absence of stent assistance are significant risk factors for the postoperative recurrence of an aneurysm. Strict follow-up plans should be created for ISA patients having these high-risk factors.
本研究旨在确定血管内治疗后颅内囊状动脉瘤（ISA）复发的危险因素。这些发现将有助于医学专业人员识别ISA复发风险高的患者，并协助他们制定适当的随访计划。
在随访期间，12.6%的患者（83/658）出现了ISA复发。对包括性别、年龄、高血压、糖尿病、吸烟、肿瘤大小、动脉瘤颈宽度、是否破裂、体积栓塞率（VER）、是否应用支架以及随访时间等相关因素进行分析后发现，直径>10mm的肿瘤大小、宽颈动脉瘤、前交通或大脑中动脉动脉瘤、动脉瘤破裂、VER<20%、无支架辅助以及随访时间是ISA复发的高危因素。
我们回顾性分析了2010年1月至2014年12月期间接受血管内治疗的658例ISA患者的记录。对通过单变量筛选分析确定的候选危险因素进行多变量逻辑回归分析。
吸烟、肿瘤体积大、宽颈动脉瘤、前交通或大脑中动脉动脉瘤、动脉瘤破裂、VER<20%以及无支架辅助是动脉瘤术后复发的重要危险因素。对于有这些高危因素的ISA患者，应制定严格的随访计划。
