Song Yunfei, Song Guoqiang, Liu Guijing, Mao Limei, An Xiuhu, Peng Chao, Li Jian, Chen Yan, Li Hongwen, Hou Changkai, Wang Bangyue, Zhao Yan, Wang Xiangdong, Yin Gangfeng, Yang Xinyu
Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China.
Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China.
Brain Behav. 2025 Jan;15(1):e70234. doi: 10.1002/brb3.70234.
The study evaluated the effectiveness and safety of single-stage versus multistage endovascular treatment in subarachnoid hemorrhage patients with Mirror Aneurysms.
Our research team performed a prospective study, focusing on the radiographic and clinical data of patients diagnosed with subarachnoid hemorrhage, specifically those who presented with Mirror Aneurysms upon admission to our institutions. According to the different endovascular treatment stages, these patients were grouped into the multistage cohort and the single-stage cohort.
A total of 216 aneurysms were identified among the 108 patients, with every patient having one ruptured aneurysm. The duration of follow-up was 2 years in both groups. In the single-stage cohort, all 114 aneurysms in 57 patients were managed during a single session. During the 2-year follow-up, it was observed that 49 patients achieved a modified Rankin Scale score ≤2. Five complications were encountered, including cerebral vasospasm in three patients, cerebral hemorrhage in one patient, and thromboembolism in one patient. In the multistage cohort, only the ruptured aneurysm (amounting to 51 in total) received treatment at the initial occurrence, while the remaining 51 aneurysms were addressed subsequently. Throughout the 2-year follow-up period, 46 subjects exhibited a modified Rankin scale score ≤2. Overall, four complications were documented, including cerebral vasospasm in two patients, a subarachnoid hemorrhage in one patient, and thromboembolism in one patient.
The safety and effectiveness of both endovascular treatment groups have been verified for patients with Mirror Aneurysms suffering from subarachnoid hemorrhage. If feasible, single-stage embolization should be considered a viable treatment option for these patients.
本研究评估了单阶段与多阶段血管内治疗在患有镜像动脉瘤的蛛网膜下腔出血患者中的有效性和安全性。
我们的研究团队进行了一项前瞻性研究，重点关注被诊断为蛛网膜下腔出血患者的影像学和临床数据，特别是那些入院时患有镜像动脉瘤的患者。根据不同的血管内治疗阶段，将这些患者分为多阶段队列和单阶段队列。
108例患者共识别出216个动脉瘤，每位患者有1个破裂动脉瘤。两组的随访时间均为2年。在单阶段队列中，57例患者的114个动脉瘤均在一次手术中得到处理。在2年的随访期间，观察到49例患者的改良Rankin量表评分为≤2。出现了5例并发症，包括3例脑血管痉挛、1例脑出血和1例血栓栓塞。在多阶段队列中，仅在最初发生时对破裂动脉瘤（共51个）进行了治疗，其余51个动脉瘤随后进行处理。在整个2年的随访期内，46例患者的改良Rankin量表评分为≤2。总体而言，记录了4例并发症，包括2例脑血管痉挛、1例蛛网膜下腔出血和1例血栓栓塞。
对于患有镜像动脉瘤的蛛网膜下腔出血患者，两种血管内治疗组的安全性和有效性均已得到验证。如果可行，单阶段栓塞应被视为这些患者的一种可行治疗选择。
