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首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >Single-centre comparison of procedural complications, clinical outcome, and angiographic follow-up between coiling and stent-assisted coiling for posterior communicating artery aneurysms
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Single-centre comparison of procedural complications, clinical outcome, and angiographic follow-up between coiling and stent-assisted coiling for posterior communicating artery aneurysms

机译：单中心比较后路连通性动脉瘤的线圈和支架辅助线圈之间的程序并发症，临床结果和血管造影随访

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Aneurysm recurrence is a principle limitation of endovascular coiling procedures, especially in posterior communicating artery aneurysms, with reported recurrence rates of >30%. The adjunctive use of self-expandable stents has revolutionised the treatment of intracranial aneurysms, especially for complex morphologies, wide necks, or unfavourable dome-to-neck ratios. However, there are limited data concerning a direct comparison between simple coiling and stent-assisted coiling in posterior communicating artery aneurysms. This study aimed to compare the durability and outcomes of coiling versus stent-assisted coiling procedures. Imaging data of patients with posterior communicating artery aneurysms treated with coiling or stent-assisted coiling between January 2008 and October 2012 were retrospectively analysed. The initial angiographic results, procedural complications, and clinical outcomes were assessed at discharge. Imaging follow-up was performed with cerebral angiography. Complete aneurysm occlusion was achieved on initial angiography in 23/56 (41.1%) stent and 83/235 (35.3%) non-stent patients. At the latest follow-up (mean follow-up 14.3 +/- 10.4 months for stent and 13.2 +/- 9.5 months for non-stent patients), aneurysms had recurred in 5/47 (10.6%) stent and 57/203 (28.1%) non-stent patients (p = 0.014). Procedural complications occurred in 6/56(10.7%) stent and 27/235 (11.5%) non-stent aneurysms. No rebleeding occurred during clinical follow-up (mean duration, 46.7 months). Recurrence rates at the latest follow-up were significantly lower in patients undergoing stent-assisted coiling than those undergoing simple coiling. Thus, use of the stent-assisted neck remodelling technique in the treatment of wide-necked posterior communicating artery intracranial aneurysms appears to improve the long-term clinical outcome. (C) 2014 Elsevier Ltd. All rights reserved.
机译：动脉瘤复发是血管内卷曲手术的原则限制，尤其是在后交通动脉瘤中，据报道复发率> 30％。自扩张式支架的辅助使用已彻底改变了颅内动脉瘤的治疗方法，尤其是对于复杂形态，宽颈或不利的穹顶颈比。但是，关于在后交通动脉瘤中简单卷绕和支架辅助卷绕之间直接比较的数据有限。这项研究的目的是比较卷绕和支架辅助卷绕程序的耐用性和结果。回顾性分析2008年1月至2012年10月间采用盘绕或支架辅助盘绕治疗的后交通动脉瘤患者的影像学数据。出院时评估初始血管造影结果，手术并发症和临床结局。影像学随访是通过脑血管造影进行的。初次血管造影时，在23/56（41.1％）的支架和83/235（35.3％）的非支架患者中，动脉瘤完全闭塞。在最新的随访中（支架的平均随访时间为14.3 +/- 10.4个月，非支架患者的平均随访时间为13.2 +/- 9.5个月），在5/47（10.6％）的支架和57/203（ 28.1％）非支架患者（p = 0.014）。手术并发症发生在6/56（10.7％）支架和27/235（11.5％）的非支架动脉瘤中。临床随访期间（平均持续时间46.7个月）未发生再出血。在最近的随访中，进行支架辅助卷绕的患者的复发率明显低于单纯卷绕的患者。因此，使用支架辅助颈部重塑技术治疗宽颈后交通动脉颅内动脉瘤似乎可以改善长期临床疗效。 （C）2014 Elsevier Ltd.保留所有权利。

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