中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
2期
183-188
,共6页
孙贞魁%李永东%顾斌贤%李明华%谭华桥%王武%宋冬雷%冷冰%王珏%张培蕾
孫貞魁%李永東%顧斌賢%李明華%譚華橋%王武%宋鼕雷%冷冰%王玨%張培蕾
손정괴%리영동%고빈현%리명화%담화교%왕무%송동뢰%랭빙%왕각%장배뢰
颅内动脉瘤%栓塞,治疗性%弹簧圈%支架%病例对照研究
顱內動脈瘤%栓塞,治療性%彈簧圈%支架%病例對照研究
로내동맥류%전새,치료성%탄황권%지가%병례대조연구
Intracranial aneurysm%Embolization,therapeutic%Coil%Stent%Case-control studies
目的 比较Willis覆膜支架和弹簧圈栓塞治疗颅段颈内动脉瘤的临床效果.方法 89例经皮动脉穿刺行全脑选择性血管造影术证实的颅段颈内动脉瘤患者,根据其意愿分为A组43例,行Willis覆膜支架治疗;B组46例,行弹簧圈治疗.术后3、6、12个月及之后每年1次进行脑血管造影及临床随访,搜集血管造影及临床资料进行分析.对2组患者的手术成功率及并发症发生率进行x2检验,对即刻血管造影结果、手术时间、住院时间进行独立样本t检验.结果 A组患者支架成功置入42例,失败1例;B组46例弹簧圈栓塞均获成功,2组差异无统计学意义(Fisher精确概率法,P=0.999).即刻肭血管造影显示A组34例动脉瘤完全闭塞(81%),B组24例完全闭塞(52%);平均手术时间A组(103±13)min,B组(143±39)min,2组间差异有统计学意义(t=6.20,P＜0.01＝.并发症A组6例,B组8例,2组差异无统计学意义(x2=0.20,P＞0.05).A组41例随访6～41个月,脑血管造影显示39例动脉瘤完全闭塞(95%);B组45例随访7～47个月,22例完全闭塞(49%),2组差异有统计学意义(P＜0.01＝.最后一次随访结果显示,完全康复A组22例、B组27例,2组间差异无统计学意义(x2=0.352,P＞0.05).结论 脑血管造影结果显示Willis覆膜支架置入术治疗颅段动脉瘤的结果优于弹簧圈栓塞术,而临床表现2组无明显差别.
目的 比較Willis覆膜支架和彈簧圈栓塞治療顱段頸內動脈瘤的臨床效果.方法 89例經皮動脈穿刺行全腦選擇性血管造影術證實的顱段頸內動脈瘤患者,根據其意願分為A組43例,行Willis覆膜支架治療;B組46例,行彈簧圈治療.術後3、6、12箇月及之後每年1次進行腦血管造影及臨床隨訪,搜集血管造影及臨床資料進行分析.對2組患者的手術成功率及併髮癥髮生率進行x2檢驗,對即刻血管造影結果、手術時間、住院時間進行獨立樣本t檢驗.結果 A組患者支架成功置入42例,失敗1例;B組46例彈簧圈栓塞均穫成功,2組差異無統計學意義(Fisher精確概率法,P=0.999).即刻肭血管造影顯示A組34例動脈瘤完全閉塞(81%),B組24例完全閉塞(52%);平均手術時間A組(103±13)min,B組(143±39)min,2組間差異有統計學意義(t=6.20,P＜0.01＝.併髮癥A組6例,B組8例,2組差異無統計學意義(x2=0.20,P＞0.05).A組41例隨訪6～41箇月,腦血管造影顯示39例動脈瘤完全閉塞(95%);B組45例隨訪7～47箇月,22例完全閉塞(49%),2組差異有統計學意義(P＜0.01＝.最後一次隨訪結果顯示,完全康複A組22例、B組27例,2組間差異無統計學意義(x2=0.352,P＞0.05).結論 腦血管造影結果顯示Willis覆膜支架置入術治療顱段動脈瘤的結果優于彈簧圈栓塞術,而臨床錶現2組無明顯差彆.
목적 비교Willis복막지가화탄황권전새치료로단경내동맥류적림상효과.방법 89례경피동맥천자행전뇌선택성혈관조영술증실적로단경내동맥류환자,근거기의원분위A조43례,행Willis복막지가치료;B조46례,행탄황권치료.술후3、6、12개월급지후매년1차진행뇌혈관조영급림상수방,수집혈관조영급림상자료진행분석.대2조환자적수술성공솔급병발증발생솔진행x2검험,대즉각혈관조영결과、수술시간、주원시간진행독립양본t검험.결과 A조환자지가성공치입42례,실패1례;B조46례탄황권전새균획성공,2조차이무통계학의의(Fisher정학개솔법,P=0.999).즉각눌혈관조영현시A조34례동맥류완전폐새(81%),B조24례완전폐새(52%);평균수술시간A조(103±13)min,B조(143±39)min,2조간차이유통계학의의(t=6.20,P＜0.01＝.병발증A조6례,B조8례,2조차이무통계학의의(x2=0.20,P＞0.05).A조41례수방6～41개월,뇌혈관조영현시39례동맥류완전폐새(95%);B조45례수방7～47개월,22례완전폐새(49%),2조차이유통계학의의(P＜0.01＝.최후일차수방결과현시,완전강복A조22례、B조27례,2조간차이무통계학의의(x2=0.352,P＞0.05).결론 뇌혈관조영결과현시Willis복막지가치입술치료로단동맥류적결과우우탄황권전새술,이림상표현2조무명현차별.
Objective To evaluate the clinical results of Willis covered stent implantation and coil embolization in the treatment of cranial internal carotid artery (CICA) aneurysm. Methods Eighty-nine patients with CICA aneurysms were selected for treatment with Willis covered stents (n = 43, group A) or coil embolization (n =46, group B) according to the patients'will. Data on the technical success, initial procedure time and in-hospital interval, initial and final angiographic results, mortality, morbidity, and final clinical outcomes were collected and analyzed for the two groups at 6 months post-procedure. Results Endovascular covered stent placement and coil embolization were technically successful in all patients,except for one patient in group A. The initial angiographic results showed complete occlusion in 34 patients of group A (81%, 95% CI: 69%, 93% ) and 24 patients of group B (52%, 95% CI: 37%, 67% ) ( P ＜0. 05). The final angiographic results indicated complete occlusion in 39 patients of group A (39/41,95%,95% CI: 88%, 102% ) and 22 patients of group B (22/45,49%, 95% CI: 34%, 64% ,P ＜0. 01 ). The average procedure time was(103 ± 13)min in group A and (143 + 39) min in group B (P＜0. 01). No significant differences were seen between the two groups in technique success, mortality, morbidity, or final clinical outcomes. Conclusion In this nonrandomized, prospective trial, CICA aneurysm treatment with covered stents yielded midterm angiographic results that were superior to those of coil embolization.
