Ho Michael J, Göricke Sophia L, Mummel Petra, Mönninghoff Christoph, Wrede Karsten, Wanke Isabel
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.
eNeurologicalSci. 2018 Jan 28;10:31-36. doi: 10.1016/j.ensci.2018.01.001. eCollection 2018 Mar.
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.
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.
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.
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.
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。
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。
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。
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。
