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未破裂颅内动脉瘤行诊断性数字减影脑血管造影后即刻行线圈栓塞术的优势:患者视角。

Advantages of Coil Embolization Performed Immediately After Diagnostic Cerebral Digital Subtraction Angiography in Unruptured Intracranial Aneurysms: Patients' Perspective.

机构信息

Department of Neurosurgery, College of Medicine, Yeungnam University, Namgu, Daegu, Korea.

Department of Neurosurgery, College of Medicine, Yeungnam University, Namgu, Daegu, Korea.

出版信息

World Neurosurg. 2019 Oct;130:e573-e576. doi: 10.1016/j.wneu.2019.06.154. Epub 2019 Jun 27.

Abstract

BACKGROUND

We are inevitably faced with the need to perform coil embolization immediately after diagnostic cerebral digital subtraction angiography (DSA) for economic reasons, patient convenience, fear of rupture, and other reasons. Here we report the advantages of coil embolization performed immediately after diagnostic cerebral DSA for unruptured intracranial aneurysms (UIAs) from the patients' perspective.

METHODS

Between January 2017 and October 2018, 145 patients were treated for UIAs with endovascular coil embolization at the Yeungnam University Medical Center. There were 87 patients in the group in which coil embolization was to be performed at least 1 week after diagnostic cerebral DSA (regular [R] group) and 58 patients in the group in which coil embolization was to be performed immediately after diagnostic cerebral DSA (immediate [I] group).

RESULTS

There were no statistically significant between group differences in any factor analyzed expect for medical expenses (out-of-pocket costs), 2,218,416 KRW (1963 USD) for the R group and 1,128,906 KRW (999 USD) for the I group (P < 0.001). There were no statistically significant differences in the rate of complications between the 2 groups, with 4 minor complications and 1 death in the R group and 3 minor complications and 1 death in the I group.

CONCLUSIONS

Our findings indicate that coil embolization performed immediately after diagnostic cerebral DSA can be a relatively safe alternative approach to treating patients with UIAs.

摘要

背景

出于经济原因、患者方便、担心破裂等原因,我们不可避免地需要在诊断性脑数字减影血管造影(DSA)后立即进行线圈栓塞。在此,我们从患者的角度报告了在诊断性脑 DSA 后立即对未破裂颅内动脉瘤(UIAs)进行线圈栓塞的优势。

方法

在 2017 年 1 月至 2018 年 10 月期间,我们在延世大学医疗中心对 145 例 UIAs 患者进行了血管内线圈栓塞治疗。其中 87 例患者在诊断性脑 DSA 后至少 1 周进行线圈栓塞(常规[R]组),58 例患者在诊断性脑 DSA 后立即进行线圈栓塞(即刻[I]组)。

结果

除医疗费用(自费)外,两组间无统计学意义的任何因素差异,R 组为 2,218,416 韩元(1963 美元),I 组为 1,128,906 韩元(999 美元)(P<0.001)。两组间并发症发生率无统计学意义差异,R 组有 4 例轻微并发症和 1 例死亡,I 组有 3 例轻微并发症和 1 例死亡。

结论

我们的研究结果表明,在诊断性脑 DSA 后立即进行线圈栓塞可以作为治疗 UIAs 患者的一种相对安全的替代方法。

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