对影响颅内动脉瘤弹簧圈填塞率的相关因素的探讨  

Discussion on the factors related with intracranial aneurysm recurrence after endovascular coil embolization

作　　者：郑永涛[1] 刘盈君[1] 徐锋[1] 徐强[2] 冷冰[1] 

机构地区：[1]复旦大学附属华山医院神经外科,上海200040 [2]复旦大学附属华山医院影像科,上海200040

出　　处：《中华神经外科杂志》2015年第3期254-258,共5页Chinese Journal of Neurosurgery

基　　金：上海市科学技术委员会科研计划项目（09DZ1907503）

摘　　要：目的 评估颅内动脉瘤体积、部位、是否破裂、辅助工具和填塞率的关系,进一步探讨填塞率对动脉瘤栓塞后复发的影响.方法 搜集自2009年12月至2011年11月之间的在华山医院神经外科行血管内栓塞治疗且得到随访的199例患者,共计221个颅内动脉瘤.将动脉瘤按照体积大小分为四组：＜ 65 mm3组（Ⅰ组）,65～523 mm3组（Ⅱ组）,524 ～1 726 mm3组（Ⅲ组）,＞1 726 mm3组（Ⅳ组）.所有患者根据随访时的影像学检查分为复发或者未复发.结果 不同体积组的颅内动脉瘤的填塞率差异有统计学意义（P＜0.05）.破裂动脉瘤的填塞率低于未破裂动脉瘤填塞率,结果差异有统计学意义（20.7％ VS 24.5％,P=0.029）.在Ⅰ组动脉瘤中,填塞率大于19％的动脉瘤未出现复发;在Ⅱ组动脉瘤中,填塞率大于24％的动脉瘤未出现复发.在Ⅲ组和Ⅳ组动脉瘤中,复发与未复发动脉瘤之间的填塞率差异无统计学意义.结论 动脉瘤体积和破裂状态可以影响动脉瘤的填塞率,而一定高的填塞率可以减少动脉瘤栓塞后复发的可能.Objective To assess the relation between aneurysm volume,location,rupture statue,stent and packing density in cerebral aneurysms treated with coils.Methods Two hundred and twentyone aneurysms in 199 patients were treated with coils in Huashan hospital between December 2009 and November 2011.Those intracranial aneurysm could be graded according to volume into Group Ⅰ with a volume smaller than 65mm3,Group Ⅱ between 65mm3 to 523mm3,Group Ⅲ between 523mm3 to 1726mm3,Group Ⅳ smaller than 1726mm3.The results of angiography at follow-up were dichotomized into presence or absence of recurrence.Results Large aneurysm volume was associated with low packing and frequent compaction （P 〈 0.05）.Ruptured aneurysms had a significant lower packing density than unruptured aneurysms （20.7% VS 24.5%,P =0.029）.If the aneurysm volume was packed for 24% or more with coils,compaction did not occur in aneurysms with a volume of less than 523 mm3.In small aneurysms with volumes of less than 65 mm3,compaction did not occur when packing was above 19%.Conclusions Aneurysm volume and rupture statue could influence the packing density.An effective packing density was sensible in trying to avoid aneurysm recurrence after endovascular coil embolization.

关 键 词：动脉瘤 填塞率 体积 破裂 复发 

分 类 号：R651.12[医药卫生—外科学]