支架辅助栓塞治疗颅内破裂宽颈动脉瘤的安全性和有效性:Solitaire支架和Neuroform支架的比较
Safety and efficacy of stent assisted embolization for ruptured wide-necked intracranial aneurysms:Solitaire stents versus Neuroform stents
朱云中 1周庆 1陈锐 1周海静 1韦展亮 1卢双宏1
作者信息
- 1. 530023 南宁,广西中医药大学第一附属医院神经外科
- 折叠
摘要
目的 比较Solitaire支架和Neuroform支架辅助弹簧圈栓塞治疗颅内破裂宽颈动脉瘤的安全性和有效性.方法 回顾性分析2017年9月至2022年10月支架辅助栓塞治疗的118例颅内破裂宽颈动脉瘤的临床资料,其中采用Solitaire支架45例,Neuroform支架73例.结果 术中所有支架均成功展开,无支架打开不良或移位,无弹簧圈突入载瘤动脉瘤.术后即刻造影显示,Solitaire支架组动脉瘤完全闭塞率(84.4%,38/48)与Neuroform支架组(86.3%,65/73)无统计学差异(P=0.683).Solitaire支架组1例术中出现动脉瘤破裂出血,Neuroform支架组1例术后出现局部脑缺血;两例病人出院时均无明显神经功能受损.出院时,Solitaire支架组预后良好率(86.7%,39/45)与Neuroform支架组(87.7%,64/73)无统计学差异(P=0.874).107例(90.7%,107/118)获得临床随访(102～458 d;平均145 d),Solitaire支架组末次随访预后良好率(86.0%,37/43)与Neuroform支架组(85.9%,55/64)无统计学差异(P=0.323).88例(74.8%,88/118)接受影像学随访(213～817 d;平均264 d),Solitaire支架组末次随访动脉瘤完全闭塞率(92.1%,35/38)与Neuroform支架组(90.0%,45/50)无统计学差异(P=0.670).随访期间未发生出血或缺血事件.结论 对于颅内破裂宽颈动脉瘤,采用Solitaire支架和Neuroform支架辅助栓塞治疗是安全的、有效的,二者的安全性和有效性相当.
Abstract
Objective To compare the safety and effectiveness of Solitaire stent-assisted coil embolization with Neuroform stent-assisted coil embolization for ruptured wide-necked intracranial aneurysms(RWN-IA).Methods A retrospective analysis was performed on the clinical data of 118 patients with RWN-IA who underwent stent-assisted embolization from September 2017 to October 2022.Among them,45 patients received Solitaire stents and 73 received Neuroform stents.Results All stents were successfully released,without displacement of stents and coils prolapsing into the parent arteries.Postoperative immediate angiography showed that the complete occlusion rate in the Solitaire group(84.4%,38/48)was not statistically different from that(86.3%,65/73)in the Neuroform group(P=0.683).One case in the Solitaire group experienced intraoperative aneurysm rupture,while one case in the Neuroform group experienced local cerebral ischemia after the procedure;both patients were discharged without obvious neurological deficit.At discharge,the good outcome rate in the Solitaire group(86.7%,39/45)was not statistically different from that(87.7%,64/73)in the Neuroform group(P=0.874).Among the 107 patients(90.7%,107/118)who received clinical follow-up(range 102～458 d;mean 145 d),the good outcome rate at the last follow-up in the Solitaire group(86.0%,37/43)was not statistically different from that(85.9%,55/64)in the Neuroform group(P=0.323).Among the 88 patients(74.8%,88/118)who received imaging follow-up(range 213～817 d;mean 264 d),the complete occlusion rate at the last follow-up in the Solitaire group(92.1%,35/38)was not statistically different from that(90.0%,45/50)in the Neuroform group(P=0.670).Conclusions For RWN-IA,the use of Solitaire and Neuroform stents for assisted embolization therapy is safe and effective,with similar safety and efficacy.
关键词
颅内破裂动脉瘤/宽颈动脉瘤/血管内治疗/Solitaire支架/Neuroform支架/安全性/有效性Key words
Intracranial aneurysm/Wide-necked aneurysm/Embolization/Solitaire stent/Neuroform stent/Safety/Efficacy引用本文复制引用
出版年
2024
NETL
NSTL
万方数据