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颅内动脉瘤的血管内治疗:低容量中心的初步经验。

Endovascular Treatment of Intracranial Aneurysms: Initial Experience in a Low-Volume Center.

作者信息

Gudelj Maxime, Bruyère Pierre-Julien, Tebache Malek, Collignon Laurent, Lubicz Boris

机构信息

CHR de la Citadelle, Liège, BE.

Hopital Erasme, BE.

出版信息

J Belg Soc Radiol. 2020 May 6;104(1):19. doi: 10.5334/jbsr.1918.

Abstract

OBJECTIVE

Endovascular treatment (EVT) is the first-line treatment for ruptured and unruptured intracranial aneurysms (IA). EVT may be performed by interventional neuroradiologist (INR) with different levels of experience. This study aimed at evaluating clinical and anatomic results of IA embolisations performed by a INR with a short experience.

MATERIALS AND METHODS

Within a 26-month period, 35 IA embolisations were managed by a young INR, 26 of these IA being ruptured. Different EVT techniques were used: coiling alone, stent-assisted coiling and remodeling techniques. Initial angiographic results, clinical outcomes and mid-term anatomic results were evaluated.

RESULTS

Out of 35 procedures, there were seven per-procedural complications leading to one ischemic stroke and one death. Immediate post-procedural complete occlusion was obtained in 91% of procedures (32/35). Good clinical results (modified Rankin Scale Score of 0 or 1) were obtained in 79% of patients (26/33). In a mean follow-up time of 9.5 months, stable occlusion was shown in 88% of IA (21/24).

CONCLUSION

This study suggests that IA embolisation may be performed by a recently trained INR with good clinical and anatomical outcomes.

摘要

目的

血管内治疗(EVT)是破裂和未破裂颅内动脉瘤(IA)的一线治疗方法。EVT可由经验水平不同的介入神经放射科医生(INR)进行。本研究旨在评估经验不足的INR进行IA栓塞的临床和解剖学结果。

材料与方法

在26个月的时间内,一名年轻的INR管理了35例IA栓塞,其中26例IA破裂。采用了不同的EVT技术:单纯弹簧圈栓塞、支架辅助弹簧圈栓塞和重塑技术。评估了初始血管造影结果、临床结局和中期解剖学结果。

结果

在35例手术中,有7例出现术中并发症,导致1例缺血性中风和1例死亡。91%的手术(32/35)术后即刻实现完全闭塞。79%的患者(26/33)获得了良好的临床结果(改良Rankin量表评分为0或1)。在平均9.5个月的随访时间里,88%的IA(21/24)显示为稳定闭塞。

结论

本研究表明,经验不足的INR也可进行IA栓塞,并获得良好的临床和解剖学结果。

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本文引用的文献

2
Cerebral aneurysm treatment is beginning to shift to low volume centers.颅内动脉瘤的治疗开始向低容量中心转移。
J Neurointerv Surg. 2014 Jun;6(5):349-52. doi: 10.1136/neurintsurg-2013-010811. Epub 2013 Jun 8.
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Endovascular treatment of unruptured aneurysms.未破裂动脉瘤的血管内治疗
Stroke. 2001 Sep;32(9):1998-2004. doi: 10.1161/hs0901.095600.

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