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临时支架辅助弹簧圈栓塞术作为宽颈动脉瘤的一种治疗选择

Temporary Stent-Assisted Coil Embolization as a Treatment Option for Wide-Neck Aneurysms.

作者信息

Müller M, Brockmann C, Afat S, Nikoubashman O, Schubert G A, Reich A, Othman A E, Wiesmann M

机构信息

From the Departments of Neuroradiology (M.M., C.B., S.A., O.N., M.W.)

From the Departments of Neuroradiology (M.M., C.B., S.A., O.N., M.W.).

出版信息

AJNR Am J Neuroradiol. 2017 Jul;38(7):1372-1376. doi: 10.3174/ajnr.A5204. Epub 2017 May 4.

Abstract

BACKGROUND AND PURPOSE

Simple coil embolization is often not a feasible treatment option in wide-neck aneurysms. Stent-assisted coil embolization helps stabilize the coils within the aneurysm. Permanent placement of a stent in an intracranial vessel, however, requires long-term platelet inhibition. Temporary stent-assisted coiling is an alternative technique for the treatment of wide-neck aneurysms. To date, only case reports and small case series have been published. Our purpose was to retrospectively analyze the effectiveness and safety of temporary stent-assisted coiling in a larger cohort.

MATERIALS AND METHODS

Research was performed for all patients who had undergone endovascular aneurysm treatment in our institution (University Hospital Aachen) between January 2010 and December 2015. During this period, 355 consecutive patients had undergone endovascular aneurysm treatment. We intended to treat 33 (9.2%) of them with temporary stent-assisted coiling, and they were included in this study. Incidental and acutely ruptured aneurysms were included.

RESULTS

Sufficient occlusion was achieved in 97.1% of the cases. In 94%, the stent could be fully recovered. Complications occurred in 5 patients (14.7%), whereas in only 1 case was the complication seen as specific to stent-assisted coiling.

CONCLUSIONS

Temporary stent-assisted coiling is an effective technique for the treatment of wide-neck aneurysms. Safety is comparable with that of stent-assisted coiling and coiling with balloon remodeling.

摘要

背景与目的

对于宽颈动脉瘤,单纯弹簧圈栓塞往往不是可行的治疗选择。支架辅助弹簧圈栓塞有助于将弹簧圈稳定在动脉瘤内。然而,在颅内血管中永久放置支架需要长期抑制血小板。临时支架辅助弹簧圈栓塞是治疗宽颈动脉瘤的一种替代技术。迄今为止,仅发表了病例报告和小病例系列。我们的目的是回顾性分析更大队列中临时支架辅助弹簧圈栓塞的有效性和安全性。

材料与方法

对2010年1月至2015年12月在我们机构(亚琛大学医院)接受血管内动脉瘤治疗的所有患者进行研究。在此期间,355例连续患者接受了血管内动脉瘤治疗。我们打算对其中33例(9.2%)采用临时支架辅助弹簧圈栓塞治疗,他们被纳入本研究。纳入了偶然发现的动脉瘤和急性破裂的动脉瘤。

结果

97.1%的病例实现了充分闭塞。94%的情况下,支架可以完全回收。5例患者(14.7%)出现并发症,而只有1例并发症被视为特定于支架辅助弹簧圈栓塞。

结论

临时支架辅助弹簧圈栓塞是治疗宽颈动脉瘤的有效技术。安全性与支架辅助弹簧圈栓塞和球囊重塑弹簧圈栓塞相当。

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