Higashida Tetsuhiro, Uchida Takanori, Osakabe Manabu, Takahashi Yuichi, Kanazawa Ryuzaburo
Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, Japan.
J Neuroendovasc Ther. 2020;14(9):351-357. doi: 10.5797/jnet.oa.2020-0027. Epub 2020 Jun 10.
The purpose of this study was to demonstrate the efficacy of a 14-coil (Target XL) for framing in coil embolization of small cerebral aneurysms.
Between January 2017 and December 2018, 46 patients underwent coil embolization of a small cerebral aneurysm that was less than 5 mm in maximum diameter. They were categorized into 26 patients in whom only 10-coils were used and 20 in whom Target XL was used for framing. The volume embolization rate (VER) and recanalization rate were compared between the two groups.
Although there were two patients in whom Target XL was replaced with a 10-coil for framing, no adverse events associated with the use of Target XL were noted. The mean VER of the first framing coil was significantly higher in aneurysms that were framed with Target XL than in those framed with a 10-coil (Target XL 22.6 ± 4.5%, 10-coil 17.9 ± 8.4%; p = 0.03). Furthermore, the mean VER at the end of the procedure was significantly higher in aneurysms with Target XL used for framing than in those embolized using only 10-coils (14-coil: 36.8 ± 7.8%, 10-coil: 32.0 ± 6.5%; p = 0.03). No recanalization was observed in aneurysms for which Target XL was used for framing, whereas five aneurysms embolized using only 10-coils were recanalized.
Target XL may be safe and feasible as a framing coil in coil embolization of small cerebral aneurysms, which may result in a high VER, low recanalization rate, and good outcome.
本研究旨在证明14圈（Target XL）在小型脑动脉瘤弹簧圈栓塞术中用于成篮的有效性。
在2017年1月至2018年12月期间，46例患者接受了最大直径小于5mm的小型脑动脉瘤的弹簧圈栓塞术。他们被分为两组，26例仅使用10圈弹簧圈，20例使用Target XL进行成篮。比较两组的体积栓塞率（VER）和再通率。
虽然有2例患者将Target XL换成10圈弹簧圈进行成篮，但未发现与使用Target XL相关的不良事件。用Target XL成篮的动脉瘤中，第一个成篮弹簧圈的平均VER显著高于用10圈弹簧圈成篮的动脉瘤（Target XL 22.6±4.5%，10圈弹簧圈17.9±8.4%；p = 0.03）。此外，使用Target XL成篮的动脉瘤在手术结束时的平均VER显著高于仅使用10圈弹簧圈栓塞的动脉瘤（14圈弹簧圈：36.8±7.8%，10圈弹簧圈：32.0±6.5%；p = 0.03）。使用Target XL成篮的动脉瘤未观察到再通，而仅使用10圈弹簧圈栓塞的5个动脉瘤发生了再通。
Target XL作为小型脑动脉瘤弹簧圈栓塞术中的成篮弹簧圈可能是安全可行的，这可能导致高VER、低再通率和良好的结果。
