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颅内颈内动脉眼段动脉瘤的支架辅助弹簧圈栓塞术:单中心长期随访

Stent-assisted coiling of intracranial carotid ophthalmic segment aneurysm segment aneurysms: Long-term follow-up from a single center.

作者信息

Gu Wenquan, Zhou Geng, Aldiyarova Aizada, Liu Tengyue, Zhang Yi, Liu Weidong, Meng Lingping, Gu Binxian, Li MingHua, Su Ming, Su Chen, Liu Aihua, Wang Wu

机构信息

Department of Radiology, Shanghai Punan Hospital, Shanghai, 200125, China.

Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.

出版信息

J Interv Med. 2023 Jul 31;6(3):116-120. doi: 10.1016/j.jimed.2023.07.004. eCollection 2023 Aug.

Abstract

BACKGROUND

To evaluate the efficacy of stent-assisted coiling (SAC) for the treatment of carotid ophthalmic segment aneurysm segment aneurysms (OSAs) of the internal carotid artery (ICA) through detailed long-term follow-up of a large patient cohort.

METHODS

We retrospectively analyzed 88 consecutive patients with OSAs between January 2009 and January 2020 ​at our center. Angiographic results were evaluated using the modified Raymond grading system and clinical outcomes were evaluated using the mRS scale. The primary endpoints were major aneurysm recurrence and poor clinical outcomes for at least 18 months of follow-up. The patients were asked to attend clinical follow-up assessments and possibly undergo DSA or MR via telephone.

RESULTS

We enrolled 88 patients with 99 OSAs treated with coiling, of whom 76 were treated with SAC. The coiling procedures were successful in all 88 patients. Overall, complications occurred in 8 patients (9.1%). No procedure-related mortality was observed. 67 (76.1%) experienced immediate aneurysm occlusion at the end of the procedure. Long-term angiographic follow-up (18 months) was available in 45/88 aneurysms (51%) (average 18.7 ​± ​5.2 months). Four patients continued their follow-up for 5 years after initial aneurysm treatment. After a clinical follow-up time of 28.7 months (range, 12-51 months), 85 patients (95.5%) achieved favorable clinical outcomes (mRS scores of 0-2).

CONCLUSIONS

This study indicates that SAC treatment is a safe and effective therapeutic alternative for ruptured and unruptured OSAs. The procedural risks are low with relatively long-term effectiveness.

摘要

背景

通过对大量患者队列进行详细的长期随访,评估支架辅助弹簧圈栓塞术(SAC)治疗颈内动脉(ICA)眼动脉段动脉瘤(OSA)的疗效。

方法

我们回顾性分析了2009年1月至2020年1月期间在本中心连续收治的88例OSA患者。使用改良的雷蒙德分级系统评估血管造影结果,使用mRS量表评估临床结局。主要终点是至少18个月随访期内的主要动脉瘤复发和不良临床结局。要求患者参加临床随访评估,并可能通过电话接受数字减影血管造影(DSA)或磁共振成像(MR)检查。

结果

我们纳入了88例接受弹簧圈栓塞治疗的99个OSA患者,其中76例接受了SAC治疗。所有88例患者的弹簧圈栓塞手术均成功。总体而言,8例患者(9.1%)出现并发症。未观察到与手术相关的死亡。67例(76.1%)在手术结束时实现了动脉瘤即刻闭塞。45/88个动脉瘤(51%)获得了长期血管造影随访(18个月)(平均18.7 ± 5.2个月)。4例患者在首次动脉瘤治疗后持续随访了5年。经过28.7个月(范围12 - 51个月)的临床随访,85例患者(95.5%)获得了良好的临床结局(mRS评分为0 - 2)。

结论

本研究表明,SAC治疗是破裂和未破裂OSA的一种安全有效的治疗选择。手术风险低,且具有相对长期的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e40d/10577061/c43b02b4556b/gr1.jpg

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