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在宽颈破裂动脉瘤的血管内治疗中使用临时桥接装置(Comaneci)的早期经验。

Early experience with a temporary bridging device (Comaneci) in the endovascular treatment of ruptured wide neck aneurysms.

机构信息

Radiology Department, UH St Ivan Rilski, Sofia, Bulgaria.

Neurosurgery Department, UH St Ivan Rilski, Sofia, Bulgaria.

出版信息

J Neurointerv Surg. 2018 Oct;10(10):978-982. doi: 10.1136/neurintsurg-2017-013641. Epub 2018 Feb 6.

Abstract

BACKGROUND

The difficulties in obtaining complete and stable endovascular occlusion are most evident for ruptured aneurysms exhibiting a wide neck and unfavorable geometric features. The aim of our study was to present experience with the Comaneci temporary bridging device in ruptured wide neck aneurysms.

METHODS

From May to July 2017, 29 ruptured aneurysms underwent endovascular embolization with the Comaneci device. Angiographic and clinical results were retrospectively analyzed.

RESULTS

29 ruptured intracranial aneurysms from different locations were included. Successful embolization was achieved in all lesions; complete post-procedure occlusion was seen in 25 (86%) cases. Insufficient embolization or neck remnant was observed in four cases (13.7%). Complications probably related, directly related, or indirectly related to the device occurred in 3.44% of patients (1/29 patients). At least one angiographic follow-up was performed in each of the 29 cases. The 12 month follow-up examination has yet to be done.

CONCLUSION

The Comaneci device offers a new promising and reliable technique that can safely support aneurysm coiling occlusion even in a rupture environment. However, long term monitoring of patients treated by this device is mandatory.

摘要

背景

对于颈宽且几何形态不佳的破裂动脉瘤,完全且稳定的血管内闭塞较为困难。本研究旨在介绍 Comaneci 临时桥接装置在破裂宽颈动脉瘤中的应用经验。

方法

2017 年 5 月至 7 月,采用 Comaneci 装置对 29 例破裂动脉瘤进行了血管内栓塞。回顾性分析了血管造影和临床结果。

结果

共纳入 29 例不同部位的破裂颅内动脉瘤。所有病变均成功栓塞,25 例(86%)完全闭塞。4 例(13.7%)显示不完全栓塞或颈部残留。3.44%(29 例中有 1 例)的患者发生了可能与装置直接相关、直接相关或间接相关的并发症。29 例患者中,至少对每例患者进行了一次血管造影随访。12 个月的随访检查尚未进行。

结论

Comaneci 装置提供了一种新的有前途且可靠的技术,即使在破裂环境下,也能安全地支持动脉瘤的线圈栓塞闭塞。然而,对接受该装置治疗的患者进行长期监测是必要的。

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