Deuschl Cornelius, Darkwah Oppong Marvin, Styczen Hanna, Markhardt Lisa, Wrede Karsten, Jabbarli Ramazan, Sure Ulrich, Radbruch Alexander, Forsting Michael, Wanke Isabel, Mönninghoff Christoph
Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
Clinic for Neurosurgery, University Hospital Essen, Essen, Germany.
Clin Pract. 2020 Sep 18;10(3):1257. doi: 10.4081/cp.2020.1257. eCollection 2020 Sep 4.
This retrospective study aims to compare treatment results of ruptured and unruptured pericallosal artery aneurysms (PAAs) regarding patient outcome and aneurysm recurrence after endovascular treatment (EVT) and neurosurgical treatment (NT). A total of 67 patients with PAA were admitted to our hospital, 44 patients with subarachnoidal hemorrhage (SAH) due to a ruptured PAA and 23 patients with unruptured PAA. The radiographic features of PAA were collected from pre-treatment digital subtraction angiography. In addition, demographic, clinical and radiographic parameters of all patients were recorded. Outcome was measured based on the modified Rankin scale (mRS) at 6 months after admission (favorable mRS score, 0-2 unfavorable mRS score, 3-6). Overall 46 patients underwent EVT and 21 patients NT. Six months after discharge 24 patients with SAH had a favorable outcome (mRS 0-2) and 16 patients an unfavorable outcome (mRS 3-6). Mortality rate of patients with SAH was 9.1% (4/44). Overall aneurysm recurrence was treated in 13 % of patients in the EVT cohort (6/46), whereas patients treated with NT had no recurrence. All patients with unruptured PAA had a favorable outcome. EVT and NT of PAA show comparable good results, although aneurysm recurrence occurs more often after EVT.
本回顾性研究旨在比较胼周动脉动脉瘤(PAA)破裂与未破裂情况下,血管内治疗(EVT)和神经外科治疗(NT)后的患者预后及动脉瘤复发情况。我院共收治67例PAA患者,其中44例因PAA破裂导致蛛网膜下腔出血(SAH),23例为未破裂PAA。从治疗前数字减影血管造影中收集PAA的影像学特征。此外,记录所有患者的人口统计学、临床和影像学参数。入院6个月后根据改良Rankin量表(mRS)评估预后(mRS评分0 - 2为预后良好,mRS评分3 - 6为预后不良)。总体而言,46例患者接受了EVT,21例患者接受了NT。出院6个月后,24例SAH患者预后良好(mRS 0 - 2),16例患者预后不良(mRS 3 - 6)。SAH患者的死亡率为9.1%(4/44)。EVT队列中13%的患者(6/46)出现了总体动脉瘤复发,而接受NT治疗的患者未出现复发。所有未破裂PAA患者预后均良好。PAA的EVT和NT显示出相当好的效果,尽管EVT后动脉瘤复发更常见。