支架辅助栓塞宽颈前交通动脉瘤的安全性及有效性分析

目的 探讨支架辅助栓塞宽颈前交通动脉瘤的安全性和有效性.方法 收集2015年1月至2019年12月大连医科大学附属第一医院神经外科采用介入栓塞治疗的宽颈前交通动脉瘤患者159例,其中支架辅助栓塞组67例,单纯弹簧圈栓塞组92例.支架辅助栓塞组中男性31例,女性36例,平均年龄(57.90±12.02)岁;单纯弹簧圈栓塞组中男性50例,女性42例,平均年龄(58.23±13.25)岁.比较两组患者在围手术期出血性并发症、缺血性并发症,术中脑血管痉挛发生率和术后随访结果.结果 术后即刻造影显示支架辅助栓塞组完全栓塞率为83.6％,明显高于单纯弹簧圈栓塞组68.5％,差异有统计学意义(P＜0.05).支架辅助栓塞组围手术期出血性并发症、缺血性并发症和脑血管痉挛发生率分别3.0％、13.4％和20.8％,单纯弹簧圈栓塞组围手术期出血性并发症、缺血性并发症和脑血管痉挛发生率分别为4.5％、8.7％和11.2％,两组间差异均无统计学意义(P＞0.05).随诊期内,支架辅助栓塞组复发3例,单纯弹簧圈栓塞组复发13例,差异有统计学意义(P＜0.05).结论 支架辅助栓塞宽颈前交通动脉瘤安全、有效.

Analysis of the safety and effectiveness of stent assisted embolization in wide-necked anterior communicating artery aneurysm

Objective To explore the safety and effectiveness of stent assisted embolization in wide-necked anterior communicating artery aneurysm. Methods Retrospective analysis of the basic data was performed on 159 patients with wide-necked anterior communicating artery aneurysms, who underwent endovascular interventional treatment in the First Affiliated Hospital of Dalian Medical University from January 2015 to December 2019. Among them, 67 patients were treated with stent assisted embolization and 92 patients with simple embolization. In the stent-assisted group, there were 31 males and 36 females with an average age of (57.90±12.02) years. In the coil embolization group, there were 50 males and 42 females with an average age of (58.23±13.25) years. The incidence of perioperative hemorrhagic complications, ischemic complications, intraoperative cerebral vasospasm and postoperative follow-up results were compared between the two groups of patients. Results Immediate postoperative angiography showed that the complete embolization rate in the stent-assisted group was 83.6%, which was significantly higher than 68.5% in the simple coil embolization group (P<0.05). The incidences of perioperative hemorrhagic complications, ischemic complications and cerebral vasospasm in the stent-assisted embolization group were 3.0%, 13.4% and 20.8% respectively, compared to 4.5%, 8.7% and 11.2% in the coil embolization group. There were no significant differences between the two groups (P>0.05). During the follow-up period, there were 3 cases of recurrence in the stent-assisted group and 13 cases in the simple embolization group. The recurrence rate of the stent-assisted group was significantly lower than that of the simple embolization group (P<0.05). Conclusions Stent assisted embolization of wide-necked anterior communicating artery aneurysms is safe and effective.