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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Stent placement for complex middle cerebral artery aneurysms
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Stent placement for complex middle cerebral artery aneurysms

机译：复杂脑中动脉瘤的支架置入

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Background To evaluate the safety and effectiveness of stent placement for ruptured or unruptured middle cerebral artery (MCA) aneurysms in a larger number. Methods Between October 2003 and December 2012, data for 70 patients with 72 complex MCA aneurysms treated with stents at our institution were retrospectively collected and analyzed. Results Eighty-five stents were successfully deployed in this series. However, failure of followed coiling was encountered in 2 (2.8%) tiny aneurysms of them. Of the 63 aneurysms treated with stent-assisted coiling, complete occlusion was achieved in 22 (34.9%), neck remnant in 15 (23.8%), and residual sac in 26 (36.5%). Of the 9 aneurysms treated with stent alone, the results were contrast stasis in 3 aneurysms and no change in 6. Procedure-related complications occurred in 9 (12.5%) procedures, including 7 of 27 (25.9%) with ruptured aneurysms and 2 of 45 (4.4%) with unruptured aneurysms, which resulted in 1 death and 5 disabilities. Univariate and multivariate analyses show that ruptured aneurysm is an independent factor for the outcome of these patients (odds ratio, 7.35; 95% confidence interval, 1.35-40.0). Angiographic follow-up results (mean, 10.5 ± 8.8 months) showed that 72.1% (44 of 61) were completely occluded, 4.9% (3 of 61) recurred, and others were stable or had improved. Intrastent stenosis was observed in 1 (1.6%) patient, which was managed conservatively. During a clinical follow-up period ranging from 7 to 113 months (mean, 33.0 ± 22.4 months), 1 disabled patient died from severe pneumonia, whereas the clinical status of the others had improved or was stable. Procedure-related morbidity/mortality during the follow-up for the ruptured and unruptured groups were 3.7%/3.7% and 0/0, respectively. Conclusions Our study shows that stent placement for the treatment of certain wide-neck MCA aneurysms is feasible, safe, and effective. However, stent placement for acutely ruptured MCA aneurysms harbors a much higher complication rate.
机译：背景技术为评估大量破裂或未破裂的大脑中动脉（MCA）动脉瘤的安全性和有效性。方法回顾性分析2003年10月至2012年12月在我院接受治疗的70例72例复杂MCA动脉瘤患者的资料。结果该系列成功部署了85个支架。但是，在其中的2个（2.8％）微小动脉瘤中遇到了随后的盘绕失败。在用支架辅助线圈治疗的63个动脉瘤中，完全闭塞22例（34.9％），残颈15例（23.8％），残余囊26例（36.5％）。在单独使用支架治疗的9个动脉瘤中，结果为3个动脉瘤存在造影剂淤滞，而第6个则没有变化。与程序相关的并发症发生在9个（12.5％）程序中，包括27个中的7个（25.9％）破裂的动脉瘤和2个中的2个。 45例（4.4％）动脉瘤未破裂，导致1例死亡和5例残疾。单因素和多因素分析表明，动脉瘤破裂是这些患者预后的独立因素（优势比：7.35; 95％置信区间：1.35-40.0）。血管造影随访结果（平均10.5±8.8个月）显示72.1％（占61％的44％）被完全闭塞，4.9％（占61％的3％）复发，其他患者稳定或有所改善。在1名（1.6％）患者中观察到了狭窄性狭窄，这是保守治疗的。在7到113个月的临床随访期间（平均33.0±22.4个月），有1名残疾患者死于严重的肺炎，而其他患者的临床状况有所改善或稳定。破裂组和未破裂组在随访期间与手术相关的发病率/死亡率分别为3.7％/ 3.7％和0/0。结论我们的研究表明，支架置入术治疗某些宽颈MCA动脉瘤是可行，安全且有效的。但是，用于急性破裂的MCA动脉瘤的支架置入术具有更高的并发症发生率。

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