Department of Neurosurgery, College of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
Department of Radiology, College of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Acta Neurochir (Wien). 2020 Sep;162(9):2245-2250. doi: 10.1007/s00701-020-04450-2. Epub 2020 Jun 15.
The aim of this study was to evaluate clinical and morphological factors associated with recurrence in anterior communicating artery (AcomA) aneurysms after clipping or coiling.
We retrospectively reviewed the clinical and radiologic features of consecutive 214 patients with AcomA aneurysms treated between January 2012 and December 2016 in a single tertiary institute. Univariate and multivariate analyses were performed to identify the relationship between clinical and morphological variables and recurrence.
Of 214 patients, 166 were unruptured aneurysms and 109 were treated with coiling. Overall recurrence rate was 13% (28 out of 214 aneurysms) during mean 36.9 ± 18.4-month follow-up. Multivariate logistic regression analysis showed that size greater than 10 mm (OR = 5.651; 95% CI, 1.317-24.242; p = 0.020), smoking (OR = 3.474; 95% CI, 1.342-8.996; p = 0.010), coiling (OR = 2.98; 95% CI, 1.005-8.832; p = 0.049), and anterior direction of aneurysm (OR = 3.77; 95% CI, 1.12-12.66; p = 0.032) were significantly associated with recurrence of AcomA aneurysms after treatment.
The results of this study demonstrated that coiling, large aneurysm, anterior direction, and smoking history may be independent risk factors for the recurrence of AcomA aneurysms. Therefore, careful follow-up should be needed especially in large AcomA aneurysms with anterior direction after coiling.
本研究旨在评估夹闭或栓塞治疗后前交通动脉瘤（AcomA）复发的临床和形态学因素。
我们回顾性分析了 2012 年 1 月至 2016 年 12 月在一家三级医院连续治疗的 214 例 AcomA 动脉瘤患者的临床和影像学特征。采用单因素和多因素分析来确定临床和形态学变量与复发之间的关系。
214 例患者中，166 例为未破裂动脉瘤，109 例采用血管内栓塞治疗。在平均 36.9±18.4 个月的随访中，总复发率为 13%（28/214 个动脉瘤）。多因素 logistic 回归分析显示，瘤体直径大于 10mm（OR=5.651；95%CI，1.317-24.242；p=0.020）、吸烟史（OR=3.474；95%CI，1.342-8.996；p=0.010）、血管内栓塞治疗（OR=2.98；95%CI，1.005-8.832；p=0.049）和动脉瘤的前向生长方向（OR=3.77；95%CI，1.12-12.66；p=0.032）与 AcomA 动脉瘤治疗后复发显著相关。
本研究结果表明，血管内栓塞治疗、瘤体较大、前向生长方向和吸烟史可能是 AcomA 动脉瘤复发的独立危险因素。因此，对于大型前向生长的 AcomA 动脉瘤，尤其是在栓塞治疗后，应进行密切随访。
