Dutta Gautam, Singh Daljit, Jagetia Anita, Srivastava Arvind K, Singh Hukum, Kumar Anil
Department of Neuro-Surgery, Rajendra Institute of Medical Sciences (RIMS), Jharkhand, India.
Department of Neuro-Surgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, India.
J Cerebrovasc Endovasc Neurosurg. 2021 Jun;23(2):99-107. doi: 10.7461/jcen.2021.E2020.08.008. Epub 2021 May 17.
With the development of endovascular technique and devices, large and giant intracranial aneurysms are increasingly being managed by this less invasive method. Here we discuss our experience on managing such aneurysms via endovascular technique.
Retrospective data on 42 patients with large and giant intracranial aneurysms managed by endovascular techniques between September 2015 to December 2017 at our neurosurgery institute were included in this analysis.
There were a total 42 patients with 9 giant and 33 large aneurysms in this study. Eight aneurysms were treated by parent vessel occlusion, 22 aneurysms with coils and rest 12 aneurysms were treated with stent assisted coiling. Following the procedure, Raymond class I occlusion was accomplished in 31 (73.8%) patients while class Ⅱ in 9 (21.4%) and class Ⅲ in 2 (4.8%) patients. Overall morbidity and mortality were 9.5% and 14.3% respectively and favorable outcome was seen in 80.9% patients. Significant correlation was observed with clinical outcome and initial neurological status.
The study indicates that endovascular intervention is a safe and effective method in managing large and giant intracranial aneurysms with lesser morbidity and mortality.
随着血管内技术和器械的发展，大型和巨大型颅内动脉瘤越来越多地通过这种侵入性较小的方法进行治疗。在此，我们讨论我们通过血管内技术治疗此类动脉瘤的经验。
本分析纳入了2015年9月至2017年12月在我们神经外科研究所采用血管内技术治疗的42例大型和巨大型颅内动脉瘤患者的回顾性数据。
本研究共有42例患者，其中9例为巨大动脉瘤，33例为大型动脉瘤。8例动脉瘤采用载瘤动脉闭塞治疗，22例采用弹簧圈栓塞治疗，其余12例采用支架辅助弹簧圈栓塞治疗。术后，31例（73.8%）患者达到Raymond I级闭塞，9例（21.4%）达到Ⅱ级，2例（4.8%）达到Ⅲ级。总体发病率和死亡率分别为9.5%和14.3%，80.9%的患者预后良好。观察到临床结局与初始神经状态之间存在显著相关性。
该研究表明，血管内介入治疗是治疗大型和巨大型颅内动脉瘤的一种安全有效的方法，发病率和死亡率较低。
