Suppr超能文献

急性期破裂颅内动脉瘤的支架辅助治疗:单中心经验

Stent-assisted treatment of ruptured intracranial aneurysms in the acute phase: A single center experience.

作者信息

Ho Michael J, Göricke Sophia L, Mummel Petra, Mönninghoff Christoph, Wrede Karsten, Wanke Isabel

机构信息

Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland.

Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.

出版信息

eNeurologicalSci. 2018 Jan 28;10:31-36. doi: 10.1016/j.ensci.2018.01.001. eCollection 2018 Mar.

Abstract

INTRODUCTION

The purpose of this study was to analyze the results of patients with ruptured aneurysms who were treated with a specific microstent in the acute phase of subarachnoid hemorrhage.

METHODS

Data from patients with acutely-ruptured intracranial aneurysm treated with the Neuroform stent in the period between 2003 and 2016 were retrospectively assessed, addressing aneurysm occlusion and clinical outcome with a focus on periprocedural complications.

RESULTS

Twenty-nine consecutive patients with ruptured intracranial aneurysms were included in the analysis. Periprocedural hemorrhagic complications were stated in six patients, leading to death in four. Thromboembolic complications were observed in seven patients, among whom only one affected the clinical outcome with death due to basilar thrombosis. Immediate complete occlusion and occlusion with residual neck was achieved in 79.3% of cases.

CONCLUSION

Stent-assisted coiling of acutely-ruptured aneurysms achieves good immediate aneurysm occlusion. Rates of intra- and periprocedural adverse events observed in this series were significant, but did not translate to corresponding morbidity and mortality in all cases. The retrospective analysis did not allow assessing the overall risks of endovascular therapy with stent use in ruptured and complex aneurysm when compared to the overall risks with other alternative options.

摘要

引言

本研究的目的是分析在蛛网膜下腔出血急性期使用特定微支架治疗的动脉瘤破裂患者的结果。

方法

回顾性评估2003年至2016年期间使用Neuroform支架治疗的急性颅内动脉瘤破裂患者的数据,重点关注动脉瘤闭塞情况和临床结局以及围手术期并发症。

结果

29例连续的颅内动脉瘤破裂患者纳入分析。6例患者出现围手术期出血并发症,其中4例死亡。7例患者观察到血栓栓塞并发症,其中仅1例因基底动脉血栓形成导致临床结局死亡。79.3%的病例实现了即刻完全闭塞和残留颈部的闭塞。

结论

急性破裂动脉瘤的支架辅助弹簧圈栓塞术可实现良好的即刻动脉瘤闭塞。本系列中观察到的术中和围手术期不良事件发生率较高,但并非在所有病例中都转化为相应的发病率和死亡率。与其他替代方案的总体风险相比,回顾性分析无法评估在破裂和复杂动脉瘤中使用支架进行血管内治疗的总体风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d166/5933999/0bddc227da85/gr1.jpg

相似文献

1
Stent-assisted treatment of ruptured intracranial aneurysms in the acute phase: A single center experience.
eNeurologicalSci. 2018 Jan 28;10:31-36. doi: 10.1016/j.ensci.2018.01.001. eCollection 2018 Mar.
2
Stent-Assisted Embolization for Acutely Ruptured Aneurysm.
J Neuroendovasc Ther. 2022;16(2):74-81. doi: 10.5797/jnet.oa.2021-0010. Epub 2021 Jul 6.
3
Stent-assisted coil embolization of anterior communicating artery aneurysms using the LVIS Jr stent.
Interv Neuroradiol. 2019 Feb;25(1):12-20. doi: 10.1177/1591019918798144. Epub 2018 Sep 4.
4
Flow diverter devices in ruptured intracranial aneurysms: a single-center experience.
J Neurosurg. 2018 Apr;128(4):1037-1043. doi: 10.3171/2016.11.JNS161937. Epub 2017 Apr 7.
5
[LVIS stent-assisted coil embolization in the acute stage of ruptured intracranial aneurysms].
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2020 Jul;32(7):828-834. doi: 10.3760/cma.j.cn121430-20200514-00389.
6
Ruptured dissecting aneurysm in communicating internal carotid artery segments treated using a stent-assisted endovascular technique.
Interv Neuroradiol. 2018 Apr;24(2):130-134. doi: 10.1177/1591019917747244. Epub 2018 Jan 22.
8
Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P₂ segment and distal aneurysms.
J Neurosurg. 2015 Oct;123(4):906-14. doi: 10.3171/2014.9.JNS1442. Epub 2015 Mar 13.
9
Validity of PETRA-MRA for Stent-Assisted Coil Embolization of Intracranial Aneurysms.
J Neuroendovasc Ther. 2021;15(6):352-359. doi: 10.5797/jnet.oa.2020-0039. Epub 2021 Jan 15.
10
Neuroform Atlas stent-assisted coiling of ruptured intracranial aneurysms: A multicenter study.
J Neuroradiol. 2021 Nov;48(6):479-485. doi: 10.1016/j.neurad.2020.02.006. Epub 2020 Mar 20.

引用本文的文献

1
Safety and efficacy of stent-assisted coiling ruptured intracranial aneurysms: A single-center experience.
Tzu Chi Med J. 2024 Aug 12;37(2):189-197. doi: 10.4103/tcmj.tcmj_92_24. eCollection 2025 Apr-Jun.
2
Stent-assistant versus non-stent-assistant coiling for ruptured and unruptured intracranial aneurysms: A meta-analysis and systematic review.
World Neurosurg X. 2023 Oct 13;21:100243. doi: 10.1016/j.wnsx.2023.100243. eCollection 2024 Jan.
3
Stent-Assisted Embolization for Acutely Ruptured Aneurysm.
J Neuroendovasc Ther. 2022;16(2):74-81. doi: 10.5797/jnet.oa.2021-0010. Epub 2021 Jul 6.
7
Pipeline shield with single antiplatelet therapy in aneurysmal subarachnoid haemorrhage: multicentre experience.
J Neurointerv Surg. 2019 Jul;11(7):694-698. doi: 10.1136/neurintsurg-2018-014363. Epub 2018 Dec 14.

本文引用的文献

1
Predicting Outcomes in the Era of Endovascular Therapy.
Stroke. 2017 Jan;48(1):6-7. doi: 10.1161/STROKEAHA.116.015778. Epub 2016 Dec 6.
2
Treatment of wide-necked aneurysms with the Low-profile Visualized Intraluminal Support (LVIS Jr) device: a multicenter experience.
J Neurointerv Surg. 2017 Nov;9(11):1098-1102. doi: 10.1136/neurintsurg-2016-012687. Epub 2016 Oct 27.
3
Stent-assisted coiling in ruptured cerebral aneurysms: multi-center experience in acute phase.
Radiol Med. 2017 Jan;122(1):43-52. doi: 10.1007/s11547-016-0686-6. Epub 2016 Sep 8.
4
Rapid delayed growth of ruptured supraclinoid blister aneurysm after successful flow diverting stent treatment.
BMJ Case Rep. 2016 Jul 19;2016:bcr2016012506. doi: 10.1136/bcr-2016-012506.
9
Clinical pharmacokinetics of clopidogrel and its metabolites in patients with cardiovascular diseases.
Clin Pharmacokinet. 2014 Feb;53(2):155-64. doi: 10.1007/s40262-013-0105-2.
10
Intracranial aneurysms: optimized diagnostic tools call for thorough interdisciplinary treatment strategies.
Ther Adv Neurol Disord. 2011 Sep;4(5):267-79. doi: 10.1177/1756285611415309.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验