Zhang Linfeng, Zhou Xiaobing, Liu Yong, Ding Cong, Wang Yang, Yang Hongchao
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, China.
School of Public Health, Nanchang University, Nanchang, China.
Front Neurol. 2020 Dec 10;11:609384. doi: 10.3389/fneur.2020.609384. eCollection 2020.
Heparinization is applied to prevent ischemic complications in the endovascular treatment of intracranial aneurysms, but there is no unified heparinization scheme. Diffusion-weighted imaging (DWI) can be used to evaluate ischemia after endovascular therapy for intracranial aneurysms. The goal of this study is to apply DWI to evaluate the effects of different heparinization schemes on intracranial aneurysms treated with endovascular therapy. We retrospectively reviewed 141 patients with 149 aneurysms treated with endovascular interventions from July 2019 to April 2020 at our center, including 96 aneurysms treated with local heparinization and 53 aneurysms treated with systemic heparinization. We collected the basic information of the patients, including age, sex, comorbidities, and aneurysm characteristics, and associated treatment data. New ischemic lesions detected by DWI were categorized belonging to four types. Multivariate logistic regression was used to compare the effects of different heparinization schemes on intracranial aneurysms treated with endovascular therapy. There were no significant differences in age, sex, hypertension, diabetes, and aneurysm size or location between the two groups. The incidence and distribution types of DWI abnormalities in the local heparinization groups and systemic heparinization groups were not significantly different ( > 0.05). There was a correlation between the laser engraving stent and postoperative DWI abnormalities ( < 0.003). Multivariate logistic regression analysis showed that the laser engraving stent was significantly correlated with postoperative DWI abnormalities (odds ratio, 4.71; 95% CI: 1.51-14.58; = 0.007). Compared with systemic heparinization, local heparinization does not increase the incidence of DWI abnormalities after endovascular treatment, and its application in this group of patients is safe and effective.
肝素化用于预防颅内动脉瘤血管内治疗中的缺血性并发症，但目前尚无统一的肝素化方案。弥散加权成像（DWI）可用于评估颅内动脉瘤血管内治疗后的缺血情况。本研究的目的是应用DWI评估不同肝素化方案对颅内动脉瘤血管内治疗效果的影响。我们回顾性分析了2019年7月至2020年4月在本中心接受血管内介入治疗的141例患者的149个动脉瘤，其中96个动脉瘤采用局部肝素化治疗，53个动脉瘤采用全身肝素化治疗。我们收集了患者的基本信息，包括年龄、性别、合并症和动脉瘤特征，以及相关治疗数据。DWI检测到的新缺血性病变分为四种类型。采用多因素logistic回归比较不同肝素化方案对颅内动脉瘤血管内治疗的影响。两组患者在年龄、性别、高血压、糖尿病、动脉瘤大小或位置方面无显著差异。局部肝素化组和全身肝素化组DWI异常的发生率和分布类型无显著差异（>0.05）。激光雕刻支架与术后DWI异常之间存在相关性（<0.003）。多因素logistic回归分析显示，激光雕刻支架与术后DWI异常显著相关（比值比，4.71；95%CI：1.51-14.58；=0.007）。与全身肝素化相比，局部肝素化不会增加血管内治疗后DWI异常的发生率，其在该组患者中的应用安全有效。
