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单纯弹簧圈栓塞与 Solitaire 支架辅助弹簧圈栓塞颅内分叉部动脉瘤的比较。

Comparison of Solitaire and Neuroform Stenting for Coiling of Intracranial Bifurcation Aneurysms.

机构信息

Department of Radiology, 159397Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Shanghai 200040, China.

出版信息

Interv Neuroradiol. 2023 Apr;29(2):165-171. doi: 10.1177/15910199221081249. Epub 2022 Mar 2.

Abstract

PURPOSE

To compare the technical performance and outcomes of Solitaire and Neuroform stents for treatment of intracranial bifurcation aneurysms (IBAs).

METHODS

IBAs treated by stent-assisted coiling using a Solitaire or Neuroform stent between October 2010 and December 2019 were retrospectively evaluated. Patient demographics, aneurysm information, treatment technique, periprocedural and device-related complications, parent artery angle change, along with initial and follow-up angiographic results were analyzed.

RESULTS

One hundred twenty-one patients with 121 IBAs treated with Solitaire (n = 101) or Neuroform (n = 20) stent-assisted coiling were included. Aneurysm size, thrombotic and hemorrhagic complication rate, initial occlusion rate and in-stent stenosis between the two cohorts were not significantly different. Aneurysm location was significantly different between the two groups (p = 0.032). Jailing technique rate for coiling was significantly higher in the Solitaire than the Neuroform group (70.3% vs. 35.0%, p < 0.01). Follow-up DSA demonstrated a significantly lower recurrence rate for the Solitaire cohort (2.9% vs. 22.2%, p = 0.016). Parent artery angle changes, immediately post-operative and on follow-up were significantly greater in the Solitaire stent group (p < 0.05).

CONCLUSIONS

For intracranial bifurcation aneurysms, Solitaire stent-assisted coiling achieved a significantly lower recurrence rate and induced more favorable parent artery angular remodeling than Neuroform stenting.

摘要

目的

比较 Solitaire 和 Neuroform 支架治疗颅内分叉部动脉瘤(IBAs)的技术性能和结果。

方法

回顾性分析 2010 年 10 月至 2019 年 12 月采用 Solitaire 或 Neuroform 支架辅助弹簧圈治疗的 IBA 患者。分析患者的人口统计学资料、动脉瘤信息、治疗技术、围手术期和器械相关并发症、母动脉角度变化以及初始和随访血管造影结果。

结果

共纳入 121 例采用 Solitaire(n=101)或 Neuroform(n=20)支架辅助弹簧圈治疗的 121 例 IBA 患者。两组患者的动脉瘤大小、血栓和出血性并发症发生率、初始闭塞率和支架内狭窄率无显著差异。两组患者的动脉瘤位置存在显著差异(p=0.032)。Solitaire 组的线圈填塞技术率明显高于 Neuroform 组(70.3%比 35.0%,p<0.01)。随访 DSA 显示 Solitaire 组的复发率明显较低(2.9%比 22.2%,p=0.016)。Solitaire 支架组母动脉角度的变化,术后即刻和随访时均显著大于 Neuroform 支架组(p<0.05)。

结论

对于颅内分叉部动脉瘤,Solitaire 支架辅助弹簧圈治疗的复发率明显较低,且引起的母动脉角度重塑更为有利。

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