颅内动脉瘤修复用 SMART 线圈：单中心经验。
SMART coils for intracranial aneurysm repair - a single center experience.
机构信息
Department of diagnostic and interventional Neuroradiology, University Medical Center Göttingen, Robert Koch Str. 40, 37075, Göttingen, Germany.
Department of diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert Koch Str. 40, 37075, Göttingen, Germany.
出版信息
BMC Neurol. 2020 Jan 29;20(1):38. doi: 10.1186/s12883-020-1623-9.
BACKGROUND
Due to uniform stiffness of standard platinum coils, dense packing of intracranial aneurysms can be difficult to achieve, since stiffer coils can cause microcatheter prolapse or coil migration. SMART coils have a varying softness along the length of the coils to improve deliverability. We report our initial 2 year experience with the SMART coil system, including direct and follow-up results.
METHODS
We performed a retrospective study of all patients who underwent coil embolization of an intracranial aneurysm with SMART coils between July 2016 and August 2018 at our institution. We analyzed clinical and angiographic data before and directly after treatment as well as at 6 months follow-up.
RESULTS
A total of 49 patients harboring 49 aneurysms were treated; 23 (47%) were ruptured aneurysms. Most aneurysms (57%) were located in the anterior circulation. Median patient age was 55 (31-88), 63% were female. Mean aneurysm size was: neck 3.4 (±1.5), height 6.3 (±2.9) and width 5.2 (±2.3) mm. SMART coils were solely used in 96% of cases. Initial favorable angiographic results were achieved in 45 (92%) of 49 cases, which were stable at 6 months in 26/29 (90%). Thromboembolic complications occurred in 4 (8%) cases without clinical sequelae; microcatheter prolapse occurred in 1 case. No aneurysm rupture or device malfunction was observed.
CONCLUSION
The treatment of ruptured and unruptured intracranial aneurysms with SMART Coils was safe and efficacious in our cohort.
背景
由于标准铂金线圈的刚度均匀，因此难以实现颅内动脉瘤的紧密填塞，因为较硬的线圈可能导致微导管脱出或线圈迁移。SMART 线圈沿线圈的长度具有不同的柔软度，以提高可输送性。我们报告了使用 SMART 线圈系统的最初 2 年经验，包括直接和随访结果。
方法
我们对 2016 年 7 月至 2018 年 8 月在我院接受 SMART 线圈颅内动脉瘤栓塞治疗的所有患者进行了回顾性研究。我们分析了治疗前后及 6 个月随访时的临床和血管造影数据。
结果
共治疗 49 例 49 个动脉瘤，其中 23 例（47%）为破裂动脉瘤。大多数动脉瘤（57%）位于前循环。患者年龄中位数为 55 岁（31-88 岁），63%为女性。平均动脉瘤大小为：颈宽 3.4（±1.5）mm，高 6.3（±2.9）mm，宽 5.2（±2.3）mm。96%的病例仅使用 SMART 线圈。49 例中有 45 例（92%）初始血管造影结果良好，26/29 例（90%）在 6 个月时稳定。4 例（8%）发生血栓栓塞并发症，但无临床后遗症；1 例出现微导管脱出。未观察到动脉瘤破裂或器械故障。
结论
在我们的队列中，使用 SMART 线圈治疗破裂和未破裂的颅内动脉瘤是安全有效的。
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