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Angiographic follow-up of cerebral aneurysms treated with Guglielmi detachable coils(GDCs): An analysis of 162 cases of 173 aneurysms 被引量:6

Angiographic follow-up of cerebral aneurysms treated with Guglielmi detachable coils(GDCs): An analysis of 162 cases of 173 aneurysms
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摘要 Objective To evaluate the mid- and long-term radiological outcomes of cerebral aneurysms with GDCs embolization.Methods One hundred and sixty-two patients with 173 aneurysms embolized with GDCs underwent angiographic follow-up from 1 to 54 months post-operatively and were retrospectively reviewed. Three neuro-radiologists reviewed each angiogram and made a comparison between initial and follow-up angiograms. Morphological outcomes were evaluated as follows: unchanged; progressive thrombosis; and re-opening or re-growth. Results Of 173 aneurysms with GDC embolization, 142 aneutysms had total or nearly total occlusion, 23 subtotal occlusion and 8 partial occlusion shown on initial angiograms. The incidence of re-opening was 17.1% (13/76) in less than 3 months, and 6.2% (6/97) between 3 and 6 months postoperatively. Four aneurysms showed recurrency(2.3%) on second follow-up angiography in one year after procedure and one-year cumulative recurrent rate was 13.3% of 56 aneurysms with the third follow-up angiography in the post-operation period of 12 to 54 months, four showed a little enlargement and the cmnulative recurrent rate so far was 20.2% (35/173). Conclusions The direct and main causes for aneurysmal recurrence are incomplete and loosening packing. The first angiographic follow-up is recommended to be performed at 3 months or earlier after the procedure, especially in aneurysms with initial incomplete occlusion. Re-treatment with balloon- or stent-assisted coil embolization is recommended in re-opening aneurysms. Objective To evaluate the mid-and long-term radiological outcomes of cerebral aneurysms with GDCs embolization. Methods One hundred and sixty-two patients with 173 aneurysms embolized with GDCs underwent angiographic follow-up from 1 to 54 months post-operatively and were retrospectively reviewed. Three neuro-radiologists reviewed each angiogram and made a comparison between initial and follow-up angiograms. Morphological outcomes were evaluated as follows: unchanged; progressive thrombosis; and re-opening or re-growth. Results Of 173 aneurysms with GDC embolization, 142 aneutysms had total or nearly total occlusion, 23 subtotal occlusion and 8 partial occlusion shown on initial angiograms. The incidence of re-opening was 17.1% (13/76) in less than 3 months, and 6.2% (6/97) between 3 and 6 months postoperatively. Four aneurysms showed recurrency (2.3%) on second follow-up angiography in one year after procedure and one-year cumulative recurrent rate was 13.3% of 56 aneurysms with the third follow-up angiography in the post-operation period of 12 to 54 months, four showed a little enlargement and the cmnulative recurrent rate so far was 20.2% (35/173). Conclusions The direct and main causes for aneurysmal recurrence are incomplete and loosening packing. The first angiographic follow-up is recommended to be performed at 3 months or earlier after the procedure, especially in aneurysms with initial incomplete occlusion. Re-treatment with balloon-or stent-assisted coil embolization is recommended in re-opening aneurysms.
出处 《介入放射学杂志》 CSCD 2005年第5期472-479,共8页 Journal of Interventional Radiology
基金 TheAssociationofScienceandTechnologyofShanghai(03411985)
关键词 脑动脉瘤 血管栓塞 神经介入学 放射治疗 Cerebral aneurysm GDC Embolization Follow up
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参考文献29

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同被引文献30

  • 1刘建民,许奕,洪波,赵瑞,黄清海,张珑,赵文元.颅内自膨胀支架结合弹簧圈治疗脑动脉瘤[J].介入放射学杂志,2004,13(3):196-200. 被引量:44
  • 2黄清海,刘建民,许奕,洪波.血管内支架结合弹簧圈治疗颅内宽颈动脉瘤的影像学随访结果[J].介入放射学杂志,2004,13(3):220-223. 被引量:3
  • 3施海彬,胡卫星,刘圣,王杰,杨正强,耿晓增,傅震,李麟荪.介入微弹簧圈栓塞术治疗颅内动脉瘤[J].介入放射学杂志,2006,15(10):580-584. 被引量:11
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  • 6Wanke I, Doerfler A, Schoch B, et al. Treatment of widenecked intracranial aneurysms with a self-expanding stent system: initial clinical experience [J ]. AJNR, 2003, 24 : 1192 - 1199.
  • 7Lee YJ, Kim DJ, Suh SH, et al. Stent-assisted coil embolization of intracranial wide-necked aneurysms [J]. Neuroradiology, 2005, 47:680 - 689.
  • 8Baldi S, Mounayer C, Poitin M, el al. Balloon-assisted coil placement in wide-neck bifurcation aneurysms by use of a new,compliant balloon microcatheter[J]. AJNR, 2003, 24: 1222- 1225.
  • 9Canton G, Levy DI, Lasheras JC. Hemodynamic changes due to stent placement in bifurcating intracranial aneurysms [J]. J Neurosurg, 2005, 103:146 - 155.
  • 10Weber W, Bendszus M, Kis B, et al. A new self-expanding nitinol stent (Enterprise) for the treatment of wide-necked intracranial aneurysms: initial clinical and angiographic results in 31 aneurysms[J]. Neuroradiology, 2007, 49:555 -561.

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