Department of Radiology, Inonu University School of Medicine, Malatya, Turkey.
Department of Radiology, Harran University School of Medicine, Şanlıurfa, Turkey.
Interv Neuroradiol. 2021 Oct;27(5):638-647. doi: 10.1177/15910199211005331. Epub 2021 Mar 28.
The objective of the present study is to analyze the outcomes of patients with subarachnoid hemorrhage (SAH) in the acute phase after treatment with Y-stent-assisted coiling (YSAC) embolization.
This retrospective study assessed of 30 patients with acutely ruptured wide-neck aneurysms following YSAC treatment between April 2013 and October 2019. The demographic data, aneurysm occlusion grade, procedural and periprocedural complications, and clinical outcomes were assessed.
The procedure was completed in 30 cases (90.1%) and technical failure occurred in 3 cases (9.1%). Immediate control angiography revealed that total occlusion Raymond-Ray Class 1 (RR1) was achieved in 21 (70%), neck filling (RR2) in eight (26.6%) and sac filling (RR1) in one (3.3%) aneurysm. Upon angiographic follow-up, RR1 occlusion was observed in 15 (71.4%) patients, RR2 in three (14.3%) patients and RR3 in three (14.3%) patients. In-stent thrombus developed in five (16.6%) patients; procedural ischemic events were observed in four (13.3%) patients; and two (6.6%) patients were symptomatic. A periprocedural asymptomatic intracranial hemorrhage was detected in two patients. At discharge, 17 (56.6%) patients were in good clinical condition, six (20%) were in a severe disability condition, and seven (23.3%) patients had died. At the final follow-up visit (mean: 18.9 months), 16 (76,2%) of 21 patients were in a good clinical condition and five (23.8%) had severe disabilities.
Y-stent assisted coiling in might be a feasible and promising option for treatment in acute phase in selected wide-necked ruptured intracranial aneurysms.
本研究旨在分析 Y 型支架辅助弹簧圈栓塞（YSAC）治疗后蛛网膜下腔出血（SAH）急性期患者的治疗效果。
本回顾性研究纳入了 2013 年 4 月至 2019 年 10 月期间接受 YSAC 治疗的 30 例急性宽颈破裂动脉瘤患者。评估了患者的人口统计学数据、动脉瘤闭塞等级、手术过程和围手术期并发症以及临床结局。
30 例（90.1%）患者完成了手术，3 例（9.1%）患者发生技术失败。即刻血管造影显示 21 例（70%）患者完全闭塞 Raymond-Ray 分级 1 级（RR1），8 例（26.6%）患者瘤颈残留（RR2），1 例（3.3%）患者瘤腔残留（RR1）。血管造影随访时，15 例（71.4%）患者 RR1 闭塞，3 例（14.3%）患者 RR2 闭塞，3 例（14.3%）患者 RR3 闭塞。5 例（16.6%）患者支架内血栓形成，4 例（13.3%）患者出现手术相关缺血性事件，2 例（6.6%）患者出现症状性。2 例患者在围手术期发生无症状性颅内出血。出院时，17 例（56.6%）患者临床状况良好，6 例（20%）患者处于严重残疾状态，7 例（23.3%）患者死亡。在最终随访时（平均 18.9 个月），21 例患者中有 16 例（76.2%）临床状况良好，5 例（23.8%）患者严重残疾。
Y 型支架辅助弹簧圈栓塞术可能是治疗急性宽颈破裂颅内动脉瘤的一种可行且有前途的选择。
