颈内动脉-后交通动脉瘤常规支架辅助弹簧圈栓塞治疗临床结果及复发因素分析  

Conventional stent-assisted coil embolization for internal carotid artery-posterior communicating artery aneurysms:analysis of clinical results and recurrence factors

作　　者：白京岳 孟庆斌 王子博[1] 管生[1] BAI Jingyue;MENG Qingbin;WANG Zibo;GUAN Sheng(Department of Neurointervention,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院神经介入科,450052

出　　处：《介入放射学杂志》2021年第11期1095-1099,共5页Journal of Interventional Radiology

摘　　要：目的分析常规支架辅助弹簧圈栓塞治疗颈内动脉(ICA)-后交通动脉(PComA)动脉瘤的效果及复发的危险因素。方法收集2013年1月至2019年12月在郑州大学第一附属医院接受常规支架辅助弹簧圈栓塞术治疗的ICA-PComA动脉瘤患者临床资料。采用单因素和多因素logistics回归分析确定常规支架辅助弹簧圈栓塞术后动脉瘤复发的危险因素。结果共入组患者199例(224枚动脉瘤),平均年龄为57岁,女性168例(84.4%)。平均随访时间12个月,20例患者20枚(8.9%)动脉瘤复发。单因素分析结果显示,术后动脉瘤复发和未复发患者伴高血压、动脉瘤位于大弯侧、破裂动脉瘤、动脉瘤直径、瘤颈宽、瘤颈口有优势PComA、流入道未致密栓塞、第1枚弹簧圈成篮即刻造影差异均有统计学意义(均P<0.05)。多因素logistics回归分析显示,伴高血压、动脉瘤破裂、动脉瘤直径≥5 mm、瘤颈口有优势PComA、流入道未致密填塞、第1枚弹簧圈成篮未覆盖瘤颈口是术后动脉瘤复发的危险因素。结论伴高血压、动脉瘤破裂、动脉瘤直径≥5 mm、瘤颈口有优势PComA、流入道未致密填塞、第1枚弹簧圈成篮未覆盖瘤颈口的ICA-PComA动脉瘤患者,常规支架辅助弹簧圈栓塞术后复发风险较高。Objective To analyze the risk factors for the recurrence of internal carotid artery-posterior communicating artery(ICA-PcomA)aneurysms after conventional stent-assisted coil embolization.Methods The clinical data of patients with ICA-PcomA aneurysms,who were admitted to the First Affiliated Hospital of Zhengzhou University between January 2013 and December 2019 to receive conventional stent-assisted coil embolization,were retrospectively analyzed.Univariate and multivariate logistic regression analyses were used to evaluate the risk factors of postoperative aneurysm recurrence.Results A total of 199 consecutive patients(224 ICA-PcomA aneurysms in total)were enrolled in this study.The mean age of patients was 57 years,and 168 patients(84.4%)were females.The mean follow-up time was 12 months.Recurrence of aneurysm was observed in 20 aneurysms(8.9%)among 20 patients.Univariate analysis showed that statistically significant differences in coexisting hypertension,aneurysm located at the large bend side,rupture of aneurysm,aneurysm diameter,wide-necked aneurysm,dominant PcomA at aneurysm neck,no compact embolization of aneurysm in-flow tract and immediate angiography findings after release of the first coil existed between the patients with recurrence and the patients with no recurrence(P<0.05 in all).Multivariate logistic regression analysis indicated that coexisting hypertension,rupture of aneurysm,aneurysm diameter≥5 mm,dominant PcomA at aneurysm neck,no compact embolization of aneurysm in-flow tract and uncovered aneurysm neck after the first coil release were the risk factors for postoperative aneurysm recurrence.Conclusion Patients with ICA-PcomA,who has coexisting hypertension,rupture of aneurysm,aneurysm diameter≥5 mm,dominant PcomA at aneurysm neck,no compact embolization of aneurysm in-flow tract and uncovered aneurysm neck after the first coil release,have high risks of postoperative recurrence after receiving conventional stent-assisted coiling embolization.

关 键 词：支架辅助弹簧圈栓塞 颈内动脉-后交通动脉动脉瘤 复发 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]