Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
Neuroradiology. 2021 Sep;63(9):1521-1530. doi: 10.1007/s00234-021-02679-x. Epub 2021 Feb 25.
Before we enter the era of flow diverter stents (FDS), the standard stent-assisted coiling technique is a well-established treatment option for routine paraclinoid aneurysms. We assess the clinical safety and efficacy of stent-assisted coiling with open-cell stent in the treatment of paraclinoid aneurysms and evaluate the association between clinical factors and follow-up aneurysm occlusion.
The clinical and radiographic data of 110 consecutive patients with 122 paraclinoid aneurysms treated with open-cell stent between April 2015 and April 2019 were analyzed retrospectively at our center. We assessed the immediate and progressive occlusion rates, complications, and clinical outcome. Multivariate analysis was performed to investigate the risk factors of angiographic incomplete occlusion.
Among 110 patients, stent-assisted coiling was successfully performed in all cases. Four (3.6%) thromboembolic events were reported during the procedure, which resulted in transient morbidity. Immediate angiography demonstrated complete occlusion in 64 (52.5%) aneurysms and no occlusion of ophthalmic artery. Angiographic follow-up at 6 months demonstrated an increase in the complete occlusion rate to 92.9%. No delayed in-stent stenosis was observed, and three aneurysms recurred. Clinical follow-up was completed in 102 patients (92.7%), and favorable outcomes were achieved in 101 (99%) patients at 6 months. Multivariate analysis showed that aneurysm size (p < 0.001) was associated with incomplete aneurysm occlusion at follow-up.
Stent-assisted coil embolization with open-cell stents is safe and effective for the treatment of paraclinoid aneurysms and provides progressive occlusion without significant in-stent stenosis events.
在血流导向装置（FDS）问世之前，标准的支架辅助弹簧圈技术是治疗常规眶周动脉瘤的成熟治疗选择。我们评估了开环支架辅助弹簧圈栓塞治疗眶周动脉瘤的临床安全性和疗效，并评估了临床因素与随访动脉瘤闭塞之间的关系。
我们回顾性分析了 2015 年 4 月至 2019 年 4 月期间在我们中心接受开环支架治疗的 110 例 122 个眶周动脉瘤患者的临床和影像学资料。我们评估了即刻和进展性闭塞率、并发症和临床结局。采用多因素分析探讨了血管造影不完全闭塞的危险因素。
在 110 例患者中，所有病例均成功进行了支架辅助弹簧圈栓塞。术中报告了 4 例（3.6%）血栓栓塞事件，导致短暂发病。即刻血管造影显示 64 个（52.5%）动脉瘤完全闭塞，无眼动脉闭塞。6 个月的血管造影随访显示完全闭塞率增加至 92.9%。未观察到支架内再狭窄，3 个动脉瘤复发。102 例患者（92.7%）完成了临床随访，6 个月时 101 例（99%）患者获得了良好的结局。多因素分析显示，动脉瘤大小（p<0.001）与随访时不完全动脉瘤闭塞相关。
开环支架辅助弹簧圈栓塞治疗眶周动脉瘤安全有效，可提供渐进性闭塞，无明显支架内再狭窄事件。
