Imamura Hirotoshi, Sakai Nobuyuki, Ito Yasushi, Sakai Chiaki, Hyodo Akio, Miyachi Shigeru, Matsumaru Yuji, Yoshimura Shinichi, Abe Toshi, Yamagami Hiroshi, Hayakawa Mikito, Sato Hiroaki, Fujinaka Toshiyuki, Tanabe Kenichiro
Department of Neurosurgery, Kobe City Medical Center General Hospital, Hyogo, Japan.
Department of Neurosurgery, Kobe City Medical Center General Hospital, Hyogo, Japan.
World Neurosurg. 2019 Jul;127:e631-e637. doi: 10.1016/j.wneu.2019.03.234. Epub 2019 Apr 1.
The effect of HydroSoft coils on the prevention of recanalization and thrombosis after embolization is unclear. We herein report the results of the single-armed prospective Japanese HydroSoft Registry.
Aneurysms with a diameter of <10 mm that were treated with a ≥50% length of HydroSoft coils were registered. We evaluated the safety and recanalization rate and analyzed the factors related to their recanalization and thrombosis 1 year later.
In total, 122 aneurysms were registered. Their mean maximum diameter and neck length were 6.4 and 3.9 mm, respectively. The mean length of the HydroSoft coils was 84.3%. No intracranial hemorrhage occurred, but 2 patients developed minor ischemic strokes. Angiographic examination immediately after the procedure showed complete obliteration, neck remnant (NR), and body filling (BF) in 20 (16.4%), 32 (26.2%), and 67 (54.9%) cases, respectively. One-year follow-up angiography showed complete obliteration, NR, and BF in 68 (55.7%), 15 (12.3%), and 15 (12.3%) cases, respectively, and 5 aneurysms (4.1%) were recanalized (4 and 1 with BF and NR as their initial angiographic result, respectively). Another 11 aneurysms still showed BF, although their thrombosis was promoted. No significant factors related to recanalization were identified. A high volume embolization ratio and small neck were significantly associated with thrombosis 1 year after embolization with HydroSoft coils.
The safety and prevention of recanalization 1 year after the treatment appeared acceptable. The high volume embolization ratio associated with HydroSoft coils could induce progression of thrombosis for aneurysms characterized by NR and BF during the follow-up period.
HydroSoft 弹簧圈在栓塞术后预防再通和血栓形成方面的效果尚不清楚。我们在此报告单臂前瞻性日本 HydroSoft 注册研究的结果。
登记直径<10 mm 且使用 HydroSoft 弹簧圈长度≥50%治疗的动脉瘤。我们评估了安全性和再通率,并分析了 1 年后与再通和血栓形成相关的因素。
共登记了 122 个动脉瘤。它们的平均最大直径和颈部长度分别为 6.4 和 3.9 mm。HydroSoft 弹簧圈的平均长度为 84.3%。未发生颅内出血,但有 2 例患者发生轻度缺血性卒中。术后立即进行的血管造影检查显示,分别有 20 例(16.4%)、32 例(26.2%)和 67 例(54.9%)完全闭塞、颈部残留(NR)和瘤体充盈(BF)。1 年随访血管造影显示,分别有 68 例(55.7%)、15 例(12.3%)和 15 例(12.3%)完全闭塞、NR 和 BF,5 个动脉瘤(4.1%)发生再通(最初血管造影结果为 BF 和 NR 的分别有 4 个和 1 个)。另外 11 个动脉瘤尽管血栓形成有所进展,但仍显示为 BF。未发现与再通相关的显著因素。高容量栓塞率和小颈部与 HydroSoft 弹簧圈栓塞术后 1 年的血栓形成显著相关。
治疗 1 年后的安全性和再通预防效果似乎可以接受。与 HydroSoft 弹簧圈相关的高容量栓塞率可能会导致随访期间以 NR 和 BF 为特征的动脉瘤血栓形成进展。