Kim J, Han H J, Lee W, Park S K, Chung J, Kim Y B, Park K Y
From the Department of Neurosurgery (J.K., H.J.H., J.C., Y.B.K., K.Y.P.).
Severance Stroke Center, and Department of Neurosurgery (W.L., S.K.P.), Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
AJNR Am J Neuroradiol. 2021 Sep;42(9):1621-1626. doi: 10.3174/ajnr.A7196. Epub 2021 Jul 1.
Stent-assisted coiling of intracranial aneurysms arising from small vessels (≤ 2.0 mm) is a common procedure. However, data regarding its treatment outcomes are scarce. This study evaluated the clinical and radiologic outcomes of stent-assisted coiling using low-profile stents for aneurysms of small parent arteries.
From November 2015 to October 2020, sixty-four patients with 66 aneurysms arising from parent arteries of ≤2.0 mm were treated with stent-assisted coiling using a Low-Profile Visualized Intraluminal Support Junior (LVIS Jr) or the Neuroform Atlas stent in a single institution. The clinical and radiologic data were retrospectively reviewed, and the risk factors for procedure-related complications were evaluated.
The LVIS Jr and Neuroform Atlas stents were used in 22 (33.3%) and 44 (66.7%) cases, respectively. Technical success was achieved in 66 cases (100%). Immediate postprocedural aneurysm occlusion grades assessed by the Raymond-Roy occlusion classification were I (57.6%), II (19.7%), and III (22.7%), respectively. Procedure-related complications occurred in 10 cases (15.2%), with 8 thromboembolic complications (12.1%) and 2 hemorrhagic complications (3.0%). Procedure-related morbidity was 4.5% without mortality. On multivariate analysis, current smoking (odds ratio = 7.1, = .021) had a statistically significant effect on procedure-related complications.
Stent-assisted coiling of intracranial aneurysms with low-profile stents in small vessels (≤ 2.0 mm) had a 100% success rate and a 15.2% overall complication rate with 4.5% morbidity. Current smoking was a significant risk factor associated with procedure-related complications.
对起源于小血管（≤2.0毫米）的颅内动脉瘤进行支架辅助弹簧圈栓塞是一种常见的手术。然而，关于其治疗效果的数据却很匮乏。本研究评估了使用低轮廓支架对小供血动脉动脉瘤进行支架辅助弹簧圈栓塞的临床和影像学结果。
2015年11月至2020年10月，在单一机构中，对64例患有66个起源于供血动脉≤2.0毫米的动脉瘤的患者，使用低轮廓可视化腔内支撑小号（LVIS Jr）或Neuroform Atlas支架进行支架辅助弹簧圈栓塞治疗。对临床和影像学数据进行回顾性分析，并评估与手术相关并发症的危险因素。
分别有22例（33.3%）和44例（66.7%）使用了LVIS Jr和Neuroform Atlas支架。66例（100%）手术获得技术成功。根据Raymond-Roy闭塞分级评估，术后即刻动脉瘤闭塞分级分别为I级（57.6%）、II级（19.7%）和III级（22.7%）。10例（15.2%）发生与手术相关的并发症,其中8例血栓栓塞并发症（12.1%），2例出血并发症（3.0%）。与手术相关的致残率为4.5%，无死亡率。多因素分析显示，当前吸烟（比值比=7.1，P=.021）对与手术相关的并发症有统计学显著影响。
使用低轮廓支架对小血管（≤2.0毫米）颅内动脉瘤进行支架辅助弹簧圈栓塞的成功率为100%，总体并发症发生率为15.2%，致残率为4.5%。当前吸烟是与手术相关并发症的一个重要危险因素。
