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水凝胶弹簧圈对脑动脉瘤的血管内栓塞评估

Evaluation of Endovascular Embolization of Cerebral Aneurysms by Hydrogel Coils.

作者信息

Knap Daniel, Gruszka Wojciech, Sieroń Dominik, Gruszczyńska Katarzyna, Zawadzki Michał, Zbroszczyk Miłosz, Baron Jan

机构信息

Department of Radiology and Interventional Radiology, Medical University of Silesia, Katowice, Poland.

Katowice School of Technology, Katowice, Poland.

出版信息

Pol J Radiol. 2017 Apr 10;82:203-208. doi: 10.12659/PJR.895675. eCollection 2017.

Abstract

BACKGROUND

Hydrogel coils were created to improve the chances of an effective endovascular treatment of cerebral aneurysms. Achieving a high packing density of coils in the lumen of aneurysms can decrease the risk of recurrence. The aim of the present study is to report our initial experience on the effectiveness and safety of endovascular treatment of intracranial aneurysms with the use hydrogel coils.

MATERIAL/METHODS: Sixty patients (age: 28-72 years) (45 women, 15 men) were treated. In 18 patients (30%), subarachnoid hemorrhage was present. Digital subtraction angiography (DSA) of cerebral vessels with rotational scanning was performed. Image analysis was performed by the Philips Integris 3D RA device,which is a specialized workstation (Three-Dimensional Rotational Angiography). 3D reconstructions of cerebral arteries were created based on the data. Sixty-six cerebral aneurysms were embolized with hydrogel coils, which expand in contact with blood. reaching the maximum diameter in about 20 minutes. In 29 aneurysms (43.9%), the effect of the procedure was confirmed on a follow-up DSA after 8.0±4.1 months from the initial treatment.

RESULTS

A complete embolization was performed in 55 aneurysms (83.3%), and partial embolization in 11 aneurysms (16.7%). In 6 aneurysms (9.1%), re-embolization was necessary and it resulted in a complete embolization of 5 aneurysms. On a follow-up DSA, complete embolization was present in 25 aneurysms (86.2%), and partial embolization in 4 aneurysms (13.8%), respectively.

CONCLUSIONS

Endovascular embolization with hydrogel coils is an effective and safe treatment method for cerebral aneurysms, although it carries the risk of some complications.

摘要

背景

水凝胶弹簧圈旨在提高颅内动脉瘤血管内有效治疗的成功率。在动脉瘤腔内实现弹簧圈的高填充密度可降低复发风险。本研究的目的是报告我们使用水凝胶弹簧圈进行颅内动脉瘤血管内治疗的有效性和安全性的初步经验。

材料/方法:治疗了60例患者(年龄:28 - 72岁)(45名女性,15名男性)。18例患者(30%)存在蛛网膜下腔出血。采用旋转扫描进行脑血管数字减影血管造影(DSA)。图像分析由飞利浦Integris 3D RA设备完成,这是一个专门的工作站(三维旋转血管造影)。基于这些数据创建了脑动脉的三维重建。66个脑动脉瘤用与血液接触后会膨胀的水凝胶弹簧圈进行栓塞,约20分钟达到最大直径。在29个动脉瘤(43.9%)中,在初始治疗后8.0±4.1个月的随访DSA中证实了手术效果。

结果

55个动脉瘤(83.3%)实现了完全栓塞,11个动脉瘤(16.7%)实现了部分栓塞。6个动脉瘤(9.1%)需要再次栓塞,其中5个动脉瘤实现了完全栓塞。在随访DSA中,分别有25个动脉瘤(86.2%)实现了完全栓塞,4个动脉瘤(13.8%)实现了部分栓塞。

结论

水凝胶弹簧圈血管内栓塞是治疗脑动脉瘤的一种有效且安全的方法,尽管存在一些并发症的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5bb/5395136/d255ea02a38e/poljradiol-82-203-g001.jpg

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