介入放射学杂志
介入放射學雜誌
개입방사학잡지
JOURNAL OF INTERVENTIONAL RADIOLOGY
2010年
4期
269-274
,共6页
施万印%李永东%李明华%高不郎%方淳%程英升%王武%李文斌%赵俊功%张培蕾%王珏%李敏
施萬印%李永東%李明華%高不郎%方淳%程英升%王武%李文斌%趙俊功%張培蕾%王玨%李敏
시만인%리영동%리명화%고불랑%방순%정영승%왕무%리문빈%조준공%장배뢰%왕각%리민
颅内动脉瘤%复发%栓塞%覆膜支架
顱內動脈瘤%複髮%栓塞%覆膜支架
로내동맥류%복발%전새%복막지가
Intracranial aneurysm%Recurrence%Embolization%covered stent
目的 报道用弹簧圈再次栓塞或覆膜支架治疗颅内复发动脉瘤的经验.方法 291例患者共305枚颅内动脉瘤行可脱卸弹簧圈治疗.随访期间,142例颅内动脉瘤中有41例(28.9%)动脉瘤复发.6个月内有脑血管造影随访的31例共31枚复发动脉瘤纳入本研究,其中20例行可脱卸弹簧圈再栓塞(A组),11例行覆膜支架置入术(B组).将动脉瘤血管造影结果 分为完全闭塞、不完全闭塞;临床评估分级为完全康复,改善,无变化,加重或进展.收集并分析技术成功率,即刻和末次血管造影结果 等资料.结果 所有复发动脉瘤弹簧圈栓塞和支架置人技术均获得成功.即刻脑血管造影示A组11例(55%)动脉瘤完全闭塞,B组8例(72.7%)完全闭塞;末次脑血管造影示A组10例(50%)动脉瘤完全闭塞,B组11例(100%)完全闭塞,两组间差异有统计学意义(P=0.005).结论 弹簧圈栓塞后动脉瘤复发,可以行弹簧圈再次栓塞术或覆膜支架置入术治疗和闭塞瘤腔.覆膜支架可能比弹簧圈栓塞能更有效地完全闭塞复发动脉瘤.
目的 報道用彈簧圈再次栓塞或覆膜支架治療顱內複髮動脈瘤的經驗.方法 291例患者共305枚顱內動脈瘤行可脫卸彈簧圈治療.隨訪期間,142例顱內動脈瘤中有41例(28.9%)動脈瘤複髮.6箇月內有腦血管造影隨訪的31例共31枚複髮動脈瘤納入本研究,其中20例行可脫卸彈簧圈再栓塞(A組),11例行覆膜支架置入術(B組).將動脈瘤血管造影結果 分為完全閉塞、不完全閉塞;臨床評估分級為完全康複,改善,無變化,加重或進展.收集併分析技術成功率,即刻和末次血管造影結果 等資料.結果 所有複髮動脈瘤彈簧圈栓塞和支架置人技術均穫得成功.即刻腦血管造影示A組11例(55%)動脈瘤完全閉塞,B組8例(72.7%)完全閉塞;末次腦血管造影示A組10例(50%)動脈瘤完全閉塞,B組11例(100%)完全閉塞,兩組間差異有統計學意義(P=0.005).結論 彈簧圈栓塞後動脈瘤複髮,可以行彈簧圈再次栓塞術或覆膜支架置入術治療和閉塞瘤腔.覆膜支架可能比彈簧圈栓塞能更有效地完全閉塞複髮動脈瘤.
목적 보도용탄황권재차전새혹복막지가치료로내복발동맥류적경험.방법 291례환자공305매로내동맥류행가탈사탄황권치료.수방기간,142례로내동맥류중유41례(28.9%)동맥류복발.6개월내유뇌혈관조영수방적31례공31매복발동맥류납입본연구,기중20례행가탈사탄황권재전새(A조),11례행복막지가치입술(B조).장동맥류혈관조영결과 분위완전폐새、불완전폐새;림상평고분급위완전강복,개선,무변화,가중혹진전.수집병분석기술성공솔,즉각화말차혈관조영결과 등자료.결과 소유복발동맥류탄황권전새화지가치인기술균획득성공.즉각뇌혈관조영시A조11례(55%)동맥류완전폐새,B조8례(72.7%)완전폐새;말차뇌혈관조영시A조10례(50%)동맥류완전폐새,B조11례(100%)완전폐새,량조간차이유통계학의의(P=0.005).결론 탄황권전새후동맥류복발,가이행탄황권재차전새술혹복막지가치입술치료화폐새류강.복막지가가능비탄황권전새능경유효지완전폐새복발동맥류.
Objective To report our experiences in the treatment of recurrent intracranial aneurysms with re-coiling or covered stents.Methods A total of 291 patients with 305 intracranial aneurysms were treated with detachable coils.and 41(28.9%)of 142 patients with aneurysms in the intemal carotid artery had a recurrent aneurysm during the follow-up period.For this study,31 recurrent aneurysms in 31 patients who had angiograms within 6 months following retreatment with detachable coils(group A,n=20)or covered stents(group B.n=11)were analysed.Aneurysms were categorised as complete or incomplete occlusion via angiographic assessment and graded as full recovery,improvement,no change or deterioration via clinical assessment.Data regarding technical success,initial and final angiographic results,final clinical outcome were collected and analysed postoperatively.Results Coil embolisation and covered stent placement.were technically successful in all recurrent aneurysms.The initial angiographic results showed complete occlusion in 11 patients(55%)in group A and in eight(72.7%)in group B(P=0.452),and the final angiographic results exhibited complete occlusion in 10 patients(50%)in group A and in 11(100%)in group B(P=0.005).There were no significant differences in technique success or final clinical outcome between the two groups.Conclusions Recurrent aneurysms after coiling can be successfully treated and occluded with re-coiling or covered stent placement.However,covered stents seem to be more effective than re-coiling with regard to complete occlusion of recurrent aneurysms.
