Department of Neurosurgery, Jinling Hospital, Nanjing Medical University, Nanjing 210002, PR China.
Department of Neurosurgery, Jinling Hospital, Nanjing Medical University, Nanjing 210002, PR China.
Clin Neurol Neurosurg. 2020 Jun;193:105786. doi: 10.1016/j.clineuro.2020.105786. Epub 2020 Mar 16.
Outcomes of endovascular treatment of anterior cerebral artery (ACA) aneurysms are still not well-characterized.
The study aimed to review the clinical effect, procedure-related complications and follow-up outcomes and to evaluate the safety and efficacy of endovascular treatment of ACA aneurysms in our center experience.
From August 2014 to August 2018, a total of 75 consecutive patients with 77 ACA aneurysms were treated via the endovascular approach after providing informed consent. A retrospective review of the clinical, radiological, and endovascular details of these patients was conducted.
The mortality and the morbidity in this study were 4% and 9.3%, respectively. Compared with A1 and A2 aneurysms, intraoperative rupture was more common in A3 aneurysms (P = 0.029). Difference between the ruptured and unruptured aneurysms in the distribution of therapeutic strategy (P = 0.003) and immediate embolization degree (P = 0.004) was also significant. Statistical analysis demonstrated that the larger aneurysm (P = 0.031) was, the greater the ratio of aneurysm size to parent artery diameter (P = 0.029) was, the more likely the unruptured aneurysms were to occur ischemic events. Higher Hunt-Hess grade (P = 0.0066) was an independent risk factor for poor clinical outcome.
Endovascular treatment is feasible and effective for ACA aneurysms.
血管内治疗大脑前动脉（ACA）动脉瘤的结果仍不明确。
本研究旨在回顾分析我院治疗 ACA 动脉瘤的临床效果、与操作相关的并发症和随访结果，评估血管内治疗 ACA 动脉瘤的安全性和有效性。
2014 年 8 月至 2018 年 8 月，对 75 例 77 个 ACA 动脉瘤患者进行了血管内治疗，患者均签署了知情同意书。回顾性分析了这些患者的临床、影像学和血管内治疗的详细资料。
本研究中死亡率和发病率分别为 4%和 9.3%。与 A1 和 A2 动脉瘤相比，A3 动脉瘤术中破裂更为常见（P=0.029）。破裂和未破裂动脉瘤在治疗策略的分布（P=0.003）和即刻栓塞程度（P=0.004）方面存在差异。统计分析表明，动脉瘤越大（P=0.031），动脉瘤与载瘤动脉直径的比值越大（P=0.029），未破裂动脉瘤发生缺血性事件的可能性越大。较高的 Hunt-Hess 分级（P=0.0066）是预后不良的独立危险因素。
血管内治疗 ACA 动脉瘤是可行和有效的。
