Effect of endovascular treatment on headaches in patients with unruptured intracranial aneurysms

BACKGROUND: Patients with unruptured intracranial aneurysms often present with headaches. OBJECTIVE: To determine the effect of endovascular treatment on the character and frequency of headaches in patients with unruptured intracranial aneurysms. METHODS: We reviewed the medical records of all patients who underwent endovascular treatment for unruptured intracranial aneurysms within a 9.5-year period. These patients were mailed a standard questionnaire in which they were asked about the frequency and character of any headache experienced before or after (or both) endovascular treatment. They were also asked to grade improvement or worsening of headaches after the procedure as mild (activities of daily living were not affected), moderate (activities of daily living were affected), or significant (the change resulted in an ability to perform new activities of daily living or an inability to perform previous activities of daily living). RESULTS: Forty-seven patients with unruptured aneurysms who underwent Guglielmi detachable coil embolization responded to the questionnaire. Of these, 32 patients (mean age, 52.7 years [SD, 13.4]; 22 were women) had experienced headaches before the procedure. Nineteen patients (59%) reported improvement in severity of headaches after embolization. Improvement was graded as significant by 7 patients, moderate by 8, and mild by 4. Two patients (6%) reported worsening severity of headaches graded as moderate. Five of 15 patients without headaches before embolization reported onset of mild (n = 4) or severe (n = 1) headaches after treatment. CONCLUSION: Guglielmi detachable coil embolization of unruptured intracranial aneurysms was associated with reduction in severity of headaches in the majority of patients who had experienced preprocedural headaches.     

Bioactive coils cause headache and fever after endovascular treatment of intracranial aneurysms

Background.— Based on our encounters with patients who have been treated for unruptured intracranial aneurysms by endovascular coil embolization using bioactive coils, we observed that such patients often present with headaches and fever. Objective.— The purpose of this study was to evaluate the incidence of headache and fever after coil embolization using bioactive coils. Methods.— A database of 92 intracranial unruptured aneurysm patients (88 patients who did not have chronic headaches or migraines before treatment) on whom coil embolization had been performed between July 2007 and October 2010 was retrospectively assessed. Forty‐five aneurysms (43 patients) were treated using bioactive coils and the other aneurysms were treated using bare coils. We analyzed the incidence and duration of headache, temperature, C‐reactive protein, and white blood cell count before and after coil embolization and compared the 2 groups. Results.— Forty‐one patients (46.6%) reported onset of headaches just after treatment. Headache incidences were significantly greater in the patients treated with bioactive coils (bioactive coil group: 62.8% [27/43] vs bare coil group: 31.1% [14/45], P = .003), and the duration of headaches was significantly longer in the bioactive coil group (bioactive coil group: 3.44 ± 1.22 days vs bare coil group: 2.40 ± 1.17 days, P = .027). Seventy‐one patients (80.7%) had incidences of fever (over 37°C) after treatment (bioactive coil group: 83.7% [36/43] vs bare coil group: 77.8% [35/45], P = .663). The duration of fever was significantly longer in the bioactive coil group (bioactive coil group: 2.9 ± 1.4 days vs bare coil group: 1.9 ± 1.1 days, P = .0017), and temperatures at 1, 2, or 3 days after treatment were significantly higher in the bioactive coil group (respective temperatures at 1, 2, 3 days after treatment: bioactive coil group: 37.42 ± 0.49, 37.19 ± 0.45, 37.00 ± 0.49 vs bare coil group: 37.14 ± 0.38, 36.96 ± 0.41, 36.63 ± 0.51, P = .009, P = .0246, P = .0032). There were no significant differences in C‐reactive protein level and white blood cell count 1 and 3 days after treatment between 2 groups. Conclusions.— Bioactive coils induce headache and fever after coil embolization for intracranial aneurysms due to the inflammatory effects of polyglycolic acid used to accelerate aneurysm fibrosis and neointimal formation.     

Clinical characteristics associated with sentinel headache in patients with unruptured intracranial aneurysms

ObjectiveSentinel headache (SH) is considered as a signal of the impending rupture of an aneurysm. However, it is difficult to diagnose whether the headaches of patients are associated with unstable aneurysms. Therefore, there is some doubt about the importance of headaches in patients with unruptured intracranial aneurysms (UIAs). This study was performed to explore the existence and clinical characteristics of SH associated with aneurysms.MethodsThirty-six patients with a single UIA were collected in this study. Patients were symptomatically categorized into two groups: SH and non-SH. The PHASES scores and patient and aneurysm characteristics were analyzed. Two independent MRI experts who were blinded to the patients’ clinical history conducted the analysis of the SWI results.ResultsThere were 15 patients with sentinel headache. No significant difference was found in patient’s basic information and history. The SH group had a higher PHASES score than the non-SH group (P < 0.05). In univariable analysis, abnormal SWI signals were significantly more frequent in the SH group (P < 0.01) and the inflow angle was significantly lower in the non-SH group (P < 0.05). In multivariable analysis, abnormal signals in SWI were an independent factor associated with SH (P < 0.01).ConclusionsSH exists in patients with UIAs and may indicate a high risk of aneurysm rupture. Abnormal signals on SWI may serve as a clinical feature to identify aneurysm-related SH and be helpful for the formulation of therapeutic strategy. Aneurysm geometry may also be related to SH but need further studies in the future.     

血管内治疗急性期破裂颅内动脉瘤的疗效观察

目的探讨血管内治疗急性期破裂颅内动脉瘤的安全性及有效性.方法回顾性分析74例颅内动脉瘤在破裂出血后72h内行血管内治疗临床资料.结果74例患者发病后均行CT检查,证实为蛛网膜下腔出血,并经全脑血管造影证实为颅内动脉瘤,共检出92枚动脉瘤,其中单发57例,2枚10例,3枚以上7例.72h内进行血管内栓塞治疗,术中根据动脉瘤的形状、大小选择合适的支架及微弹簧圈栓塞.92枚动脉瘤中,致密填塞81枚,瘤颈残余4枚,填塞不充分2例,未作栓塞处理（非重要动脉瘤）5枚.结论血管内治疗急性期破裂颅内动脉瘤安全有效,可作为其首选治疗方式.     

Angioarchitectural features amongst patients with unruptured brain arteriovenous malformations presenting with headache: findings from a single center retrospective review of 76 patients

BackgroundBrain arteriovenous malformations (AVMs) consist of abnormal connections between arteries and veins via an interposing nidus. While hemorrhage is the most common presentation, unruptured AVMs can present with headaches, seizures, neurological deficits, or be found incidentally. It remains unclear as to what AVM characteristics contribute to pain generation amongst unruptured AVM patients with headaches.MethodsTo assess this relationship, the current study evaluates angiographic and clinical features amongst patients with unruptured brain AVMs presenting with headache. Loyola University Medical Center medical records were queried for diagnostic codes corresponding to AVMs. In patients with unruptured AVMs, we analyzed the correlation between the presenting symptom of headache and various demographic and angiographic features.ResultsOf the 144 AVMs treated at our institution between 1980 and 2017, 76 were unruptured and had sufficient clinical data available. Twenty-three presented with headaches, while 53 patients had other presenting symptoms. Patients presenting with headache were less likely to have venous stenosis compared to those with a non-headache presentation (13 % vs. 36 %, p = 0.044).ConclusionsOur study suggests that the absence of venous stenosis may contribute to headache symptomatology. This serves as a basis for further study of correlations between AVM angioarchitecture and symptomatology to direct headache management in AVM patients.     

颅内宽颈动脉瘤应用血管内支架辅助介入治疗的临床效果观察

目的探究颅内宽颈动脉瘤应用血管内支架辅助介入治疗的效果观察。方法资料随机选自2012年1月-2014年1月在本院诊治的颅内宽颈动脉瘤患者72例,按随机数字表方法分成两组,每组36例,予微弹簧圈栓塞的作对照组,予微弹簧圈栓塞联合血管内支架辅助的作研究组,分析两组疗效、治疗相关指标、预后、并发症、复发等。结果研究组进行性头痛、嗜睡、动眼神经麻痹等8.33%、5.56%与2.78%,均比对照组27.78%、25.00%与19.44%少（P〈0.05）;研究组手术时间（50.36±4.73）min、住院时间（8.13±1.64）d均比对照组（66.24±5.36）min、（13.57±1.82）d少（P〈0.05）;同时随访1年研究组再出血5.56%、载瘤动脉狭窄2.78%等并发症比对照组25.00%、8.33%少（P〈0.05）;随访1年和2年研究组复发率11.11%、16.67%均比对照组30.56%、38.89%少（P〈0.05）;随访2年内研究组动脉瘤的完成闭塞率83.33%,比对照组63.89%高（P〈0.05）。结论对颅内宽颈动脉瘤予血管内支架辅助介入治疗效果显著,且预后生活质量良好,具有一定临床应用和研究价值。     

颅内动脉瘤的数字减影血管造影诊断及介入治疗

目的：总结数字减影血管造影(DSA)在颅内动脉瘤诊断中的价值及电解式可脱弹簧圈栓塞颅动脉瘤的疗效。方法：对60例蛛网膜下腔出血病例行全脑血管数字减影血管造影(DSA)检查，总结颅内动脉瘤的数字减影血管造影表现；对适合进行血管内治疗的8例进行了电解式可脱弹簧圈栓塞治疗。结果：60例中，发现颅内动脉瘤26例、共33个，其中单发病例2l例，多发病例5例；后交通动脉瘤12例，颈内动脉瘤11例，前交通动脉瘤7例，大脑中动脉瘤3例；动脉瘤呈囊状16例，梭形5例，球形4例，葫芦形4例，其他不规则形4例；动脉瘤直径在2～21mm之间；8例伴脑血管痉挛，7例动脉瘤内有血栓形成。8例GDC栓塞病例中，动脉瘤腔100％栓塞5例，95％栓塞2例，80～90％栓塞l例。弹簧圈少量脱出动脉瘤l例次，过度栓塞l例次。结论：数字减影血管造影(DSA)是确诊颅内动脉瘤不可缺少的检查方法；电解式可脱弹簧圈栓塞是一种治疗颅内动脉瘤有效的新方法。     

Early major recurrence of cerebral aneurysms after satisfactory initial coiling

Background and purposeEarly major recurrence (EMR) of cerebral aneurysms treated by coiling has not been investigated. The purpose of this study is to characterize the frequency and risk factors of this phenomenon.Materials and methodsA retrospective review was performed of consecutive patients who presented with ruptured and unruptured cerebral aneurysms and underwent coiling from July 2009 to June 2019 at a university hospital. We defined EMR as recurrence of the aneurysm greater than its initial size within the first 6 months of an initial satisfactory coil embolization. Patient demographics, clinical information, aneurysm characteristics, angiographic and technical details were reviewed.ResultsFrom July 2009 to June 2019, 338 aneurysms (190 unruptured aneurysms and 148 ruptured cerebral aneurysms) underwent coiling and satisfied our study criteria. Among these patients, 23 patients (19 ruptured and 4 unruptured aneurysms) were found to have recurrent aneurysm. Of those, 4 were found to have early major aneurysm regrowth occurring within 6 months after coiling (1.2%). The detection of the EMR was as early as 4 weeks and as late as 20 weeks after the initial coil embolization. The average detection time was 10 ± 7.2 weeks (mean ± SD, range:4-20 weeks). In each case, the recurrent aneurysm cavity was more than twice the initial size of presentation. All aneurysms with major recurrence were ruptured with low aspect ratios (dome height to neck ratio) and involved a communicating segment. All patients underwent successful retreatment of the recurrent aneurysm with good outcome.ConclusionsEarly major recurrence of treated aneurysms is a rare but important complication that harbors an impending risk of re-rupture. Early control angiography after endovascular coiling may be warranted for small ruptured aneurysms, even in cases in which the initial result seems technically satisfactory.     

Neuroform3自膨式支架在弹簧圈介入栓塞宽颈前交通动脉瘤中的作用

背景：近年来,采用支架辅助弹簧圈栓塞保持载瘤动脉通畅,防止弹簧圈脱入载瘤动脉,可显著提高疗效和安全性。目的：探讨Neuroform3自膨式支架在弹簧圈介入栓塞治疗宽颈前交通动脉瘤中的应用。方法：回顾性分析在Neuroform3自膨式支架辅助下,采用弹簧圈介入栓塞32例宽颈前交通动脉瘤患者的临床资料,其中男15例,女17例,年龄41-71岁,随访观察治疗效果及不良反应情况。结果与结论：32例患者技术操作顺利,宽颈前交通动脉共置入32枚Neuroform3支架,弹簧圈置入顺利,释放位置满意,技术成功率达到100%。在Neuroform3支架辅助水解脱弹簧圈栓塞完成后造影显示,32枚动脉瘤完全栓塞30枚,占94%;部分栓塞2枚,占6%。术后患者恢复良好,平均住院6.3 d。32例患者术后随访3-6个月,再行全脑血管造影未见再次脑出血、脑血管栓塞或动脉瘤复发。表明在Neuroform3自膨式支架辅助下采用弹簧圈介入栓塞治宽颈前交通动脉瘤,材料与宿主生物相容性好且安全有效。     

Assisted coiling using LEO Baby or LVIS Jr stents: Report of six cases

Background and purpose

Endovascular treatment of broad-neck, complex cerebral aneurysms is a challenging issue. Placement of a stent over the aneurysm neck and secondary coil embolization prevents coil migration and allows dense packing of the coils. Another challenge is represented by distal aneurysms situated in small vessels. In these cases, the use of little stents, which we are going call ministents, could be a good decision. These low-profile intracranial ministents can be deployed into arteries with diameters between 1.5 and 3.10 mm and delivered through microcatheters with an internal diameter of 0.0165 inches, which allows easier navigation in small-sized, delicate vessels. We present six cases of wide-neck aneurysms, with small parental arteries less than 2.5 mm using a low-profile ministent system (LEO Baby and LVIS Jr) plus coil embolization.

Materials and methods

We retrospectively reviewed patients in whom LEO Baby or LVIS Jr stent was used for the treatment of intracranial aneurysms. Five aneurysms were treated during 2013–2014 in our service using the LEO Baby stent and one aneurysm using LVIS Jr. Stent-assisted coil embolization was performed using the jailing technique in all cases. Clinical and angiographic findings, procedural data, and follow-up are reported.

Results

Six consecutive patients were included in this study. Four patients presented with subarachnoid hemorrhage in the subacute–chronic phase and two patients had unruptured aneurysms. Two of the six aneurysms were located at branches of the sylvian artery, one at the basilar artery, two at the anterior communicating artery, and one at the P1–P2 artery. The procedures were successful. Six-month control digital subtraction angiograms were obtained in all cases; they demonstrated complete occlusion of the aneurysms in all instances. All patients had good clinical outcomes on follow-up, as measured with the Glasgow Outcome Scale and Modified Rankin Scale.

Conclusions

The results of this small study show that the LEO Baby and LVIS Jr ministents could be safe and efficient for endovascular treatment of intracranial broad-neck aneurysms situated in small arteries.     

颅内动脉瘤旋转DSA诊断与介入治疗的探讨

目的探讨颅内动脉瘤的旋转DSA诊断和介入治疗价值。方法颅内动脉瘤患者22例,常规选择性两侧颈内动脉系正侧位造影,椎动脉系汤氏位、侧位DSA采集摄片,对怀疑血管加做180°旋转DSA检查。2例动脉瘤病人行电解可脱卸弹簧圈(Guglielmidetachablecoil,GDC)栓塞治疗。结果常规DSA检查16例瘤颈、瘤体显示清晰,4例显示欠清晰,2例未显示;在旋转DSA片中,所有病例的动脉瘤结构、全貌及与周围血管关系清晰显示。2例GDC栓塞术后1周病愈出院。结论旋转DSA是颅内动脉瘤的有效补充诊断手段。GDC栓塞技术安全、可靠,是治疗脑动脉瘤的有效方法之一。     

Y-stent-assisted coil embolization of anterior circulation aneurysms using two Solitaire AB devices: a single center experience

Wide-neck intracranial aneurysms remain a challenge to endovascular treatment. We describe our experience in repairing wide-neck aneurysms of the anterior circulation located at arterial branch points using coil embolization assisted by Y-stenting using two Solitaire(?) stents.Six wide-neck intracranial aneurysms located on the middle cerebral artery bifurcation( 3), pericallosal artery( 1), and anterior communicating artery( 2) were repaired by Y-stent-assisted coil embolization using two Solitaire(?) stents. Four cases were incidental findings of aneurysm and two cases were previously treated ruptured aneurysms that had undergone recanalization. All the cases were successfully treated without complications. Follow-up by digital subtraction angiography and magnetic resonance angiography at six months showed the stents to be patent with no recanalization of the aneurysm sacs. Repairing wide-neck aneurysms of the anterior circulation by Y-stent-assisted coil embolization using two Solitaire(?) stents is a simple and safe method of treating complex aneurysms. While the results are promising, larger series with longer term follow-ups are needed to corroborate that this treatment method is superior to other techniques.     

可膨胀水凝胶弹簧圈栓塞颅内动脉瘤的临床应用

目的探讨可膨胀水凝胶弹簧圈栓塞治疗颅内动脉瘤的安全性及临床价值。方法对24例28个动脉瘤进行了栓塞治疗，其中23个动脉瘤使用水凝胶弹簧圈栓塞。21例为破裂出血动脉瘤，其中Hunt-Hess分级I级6例，Ⅱ级9例，Ⅲ级4例，Ⅳ级2例。动脉瘤最大径3．6-17mm，平均（8．3±3．4）mm。结果完全致密栓塞20个，瘤颈残留6个，部分栓塞2个。栓塞密度为39％～124％，平均（67．6±32．3）％。暂时性对侧肢体轻偏瘫4例，脑室引流术致严重血管痉挛、颅内感染及多器官功能衰竭死亡各1例。结论可膨胀水凝胶弹簧圈栓塞治疗颅内动脉瘤安全有效，其栓塞的致密程度令人满意，其临床应用效果值得进一步研究。     

Neuroform自膨式支架联合弹簧圈栓塞治疗颅内宽颈动脉瘤的疗效分析

目的:探究Neuroform自膨式支架联合弹簧圈栓塞治疗颅内宽颈动脉瘤的临床疗效。方法:接受介入治疗的颅内宽颈动脉瘤患者152例纳入研究,根据治疗方法不同分为非支架辅助弹簧圈栓塞组(单纯弹簧圈组)56例和支架辅助弹簧圈栓塞组(支架辅助组)96例。回顾性分析患者的临床资料,比较2组治疗一般情况、并发症发生率、术前及出院时美国国立卫生院脑卒中量表(NIHSS)评分及格拉斯哥昏迷量表(GCS)评分、复发率及预后。结果:2组手术时间、术后住院时间及随访时间差异无统计学意义(P>0.05)。出院时支架辅助组NIHSS评分低于单纯弹簧圈组,GCS分数高于单纯弹簧圈组(P<0.05)。2组并发症发生率差异无统计学意义(P>0.05)。随访期间,支架辅助组复发率及mRS评分低于单纯弹簧圈组(P<0.05)。结论:对于蛛网膜下腔出血颅内宽颈动脉瘤患者,在弹簧圈栓塞的基础上联合Neuroform自膨式支架可明显提高疗效,同时降低动脉瘤的复发率,安全性高。     

Thromboelastography for monitoring platelet function in unruptured intracranial aneurysm patients undergoing stent placement

This study evaluated patients’ preoperative platelet function and the relation between acute embolic or hemorrhagic complications in unruptured intracranial aneurysm patients undergoing stent treatment.From September 2013 to December 2013 we prospectively collected clinical data in all unruptured intracranial aneurysm patients undergoing stent-assisted coiling. All patients received a dual antiplatelet therapy (aspirin and clopidogrel) protocol. Diffusion-weighted 3-T MRI was performed for cerebral aneurysm patients within 24 hours after treatment. Platelet function was tested by thromboelastography.Forty-six patients with 50 intracranial aneurysms treated by stent-assisted coiling were included. Fifty-three stents were deployed in 46 procedures, including 39 Enterprise stents and 14 Solitaire stents. Acute ischemia was detected in the territory of the stented vessel in 25 of 46 patients (54.3%), but did not cause permanent disability. There was a significant difference between groups with and without thromboembolism in terms of percentage platelet inhibition and ADP-induced clot strength (MA_ADP) for clopidogrel, but no significant difference with aspirin. MA_ADP had a predictive value yielding an area under the ROC curve of 0.67 (95% CI: 0.57–0.81, P < 0.05). Anterior circulation aneurysms were also associated with ischemic events (P = 0.034).Silent acute embolism may be frequent in unruptured intracranial aneurysm treated with stent-assisted coiling even when dual antiplatelet therapy is given. The antiplatelet inhibition parameter (MA_ADP) was a predictor for acute thromboembolism in unruptured intracranial aneurysm patients treated by stent-assisted coiling.     

颅内动脉瘤78例临床分析

目的探讨颅内动脉瘤的临床表现、诊断及治疗。方法回顾性分析78例颅内动脉瘤患者的临床表现、影像资料。结果 78例患者中共查出95个颅内动脉瘤,其中单发64例,多发性颅内动脉瘤14例(11例有2个动脉瘤,3例有3个动脉瘤),1例合并颈内动脉颅外段夹层动脉瘤,1例合并烟雾病。未破裂的颅内动脉瘤患者10例,占12.8%(10/78)。后交通动脉瘤最多见,占30.5%(29/95);动脉瘤的直径最多见于2.0～4.9mm,占63.2%(60/95),最小1.5mm,最大35mm。结论颅内动脉瘤患者常以不典型症状起病,及时诊断并及时血管内治疗,可明显降低致死率和致残率。     

水解脱弹簧圈填塞治疗急性期破裂颅内动脉瘤1例

背景：以往多采用电解脱弹簧圈填塞治疗颅内动脉瘤,但电解脱弹簧圈解脱时间较长,解脱区质地硬,并发症发生率较高,不利于微小动脉瘤的栓塞。目的：观察水解脱弹簧圈填塞治疗急性期破裂颅内动脉瘤的效果。方法：经头颅CT检查确认蛛网膜下腔出血并有脑叶出血1例,数字减影血管造影系统证实为颅内动脉瘤,采用水解脱弹簧圈栓塞动脉瘤。结果与结论：经过治疗,患者破裂动脉瘤致密栓塞,填塞达99%,出血得到控制。提示水解脱弹簧圈的超柔软性及对瘤体壁的顺应性,操作方便,提高了动脉瘤的致密性栓塞的可能性,减少并发症的可能,应该为目前急性期颅内动脉瘤破裂较好的栓塞方法。     

Hybrid,Y-configured,dual stent-assisted coil embolization in the treatment of wide-necked bifurcation aneurysms

In Y-stenting, stabilization of the first stent may be problematic as in some cases it migrates during second stent insertion. This report evaluates the safety and effectiveness of the technique and presents the long-term results of hybrid, Y-configured, dual stent-assisted coil embolization in the treatment of wide-necked bifurcation aneurysms.We retrospectively evaluated the patients treated endovascularly due to cerebral aneurysms. Twenty patients treated with hybrid Y-stent-assisted coil embolization were enrolled in the study. In hybrid stenting, an open-cell intracranial stent (Neuroform) was used as a first stent to prevent stent migration. A closed-cell stent (Enterprise or Acclino) was used as a second stent and the aneurysm was embolized with coils between the stent struts.In all patients, hybrid Y-stenting and coil embolization were accomplished successfully. No stent migration occurred. Clinically, neither symptomatic neurologic complication nor death was seen. Of 20 wide-necked bifurcation aneurysms, nine were at the basilar tip, while seven were at the middle cerebral artery and three at the anterior communicating artery. In one patient, the aneurysm was at the A2-3 junction of the anterior cerebral artery. One of the patients had a subarachnoid hemorrhage. The mean angiographic follow-up was 25.6 months. No in-stent stenosis was seen in any of the patients and recanalization in only one.Hybrid, Y-configured, dual stent-assisted coil embolization is a safe and effective method in the treatment of wide-necked bifurcation aneurysms to prevent stent migration and aneurysm recanalization, and is a viable alternative to microsurgery.     

高分辨磁共振成像在颅内未破裂动脉瘤破裂风险评估中的应用

目的探究高分辨磁共振（HR-MRI）成像在颅内未破裂动脉瘤破裂风险评估中的应用效果。方法回顾性分析2017年1月~2020年12月我院收治经过三维数字减影血管造影技术诊断为颅内动脉瘤的88例患者（101个动脉瘤）的临床资料,根据动脉是否破裂分为破裂组（n=30,35个动脉瘤）、未破裂组（n=58,66个动脉瘤）,并将未破裂组分为强化亚组（n=22,26个动脉瘤）和未强化亚组（n=36,40个动脉瘤）,所有患者均行HR-MRI成像,观察各组动脉瘤特征。结果HR-MRI成像检查与数字减影血管造影诊断结果相比,准确率为79.55%。破裂组强化率明显高于未破裂组,差异有统计学意义（P < 0.05）。破裂组与未破裂组动脉瘤位置、动脉瘤大小、是否为宽颈动脉瘤、瘤体体率比较差异无统计学意义（P>0.05）;破裂组有子囊、体颈比≥2的比例明显高于未破裂组,差异有统计学意义（P < 0.05）。强化组与未强化组动脉瘤位置、动脉瘤大小、是否为宽颈动脉瘤比较差异无统计学意义（P>0.05）;强化组有子囊、体颈比≥2、瘤体体率≥2的比例明显高于未强化组,差异有统计学意义（P < 0.05）。结论HR-MRI成像在颅内未破裂动脉瘤破裂风险评估中有良好应用效果,瘤体破裂风险与瘤壁强化有一定关系,影响瘤壁强化的因素有子囊情况及体颈比、瘤体体率等动脉瘤形态学特征。      

电解可脱性弹簧圈栓塞治疗颅内动脉瘤

目的：探讨电解可脱性弹簧圈栓塞治疗颅内动脉瘤的疗效、操作方法及技术要点。方法：回顾性分析了21例经电解可脱性弹簧圈栓塞治疗的颅内动脉瘤患者的临床资料。结果：23个动脉瘤100％栓塞17个，95％栓塞3个，90％栓塞2个，过度栓塞1个。术后随访3～14月，无再出血病饼发生，其中2例重残，3例轻残，15例恢复良好，1例死亡。结论：电解可脱性弹簧圈血管内栓塞治疗颅内动脉瘤具有安全、微创的优点，是颅内动脉瘤主要的治疗手段。