大弹簧圈技术与传统方式栓塞治疗颈内动脉-后交通动脉瘤临床效果对比分析

Large-sized coil technique versus traditional coil embolization in treating internal carotid artery-posterior communicating artery aneurysms: comparison of clinical effect

目的对比分析大弹簧圈技术与传统方式栓塞治疗颈内动脉-后交通动脉瘤的临床效果。方法选取2018年6月至2020年6月云南省第二人民医院收治的68例颈内动脉-后交通动脉瘤介入栓塞治疗患者,根据手术方法不同分为实验组(大弹簧圈技术栓塞治疗)和对照组(传统方式栓塞治疗),每组34例。比较两组术后即刻Raymond-Roy分级、动脉瘤填塞密度、弹簧圈用量、弹簧圈费用、术中支架辅助、手术并发症、出院时Glasgow预后量表(GOS)评分及术后6个月随访GOS评分。结果实验组患者术后即刻Raymond-Roy分级、弹簧圈用量、弹簧圈费用均低于对照组,动脉瘤填塞密度高于对照组,差异均有统计学意义(P<0.05)。两组患者术中支架辅助、手术并发症、出院时GOS评分及术后6个月随访GOS评分比较,差异无统计学意义(P>0.05)。结论大弹簧圈技术栓塞治疗颈内动脉-后交通动脉瘤安全有效,与传统方式相比,可提高动脉瘤栓塞密度和治愈率、降低动脉瘤复发率、减少弹簧圈用量及其费用。

Objective To compare the clinical efficacy of large-sized coil technique with that of traditional coil embolization in treating internal carotid artery-posterior communicating artery(ICA-PcomA)aneurysms. Methods A total of 68 patients with ICA-PcomA aneurysms, who were admitted to the Yunnan Provincial Second People’s Hospital of China between June 2018 and June 2020 to receive interventional embolization therapy, were enrolled in this study. According to therapeutic methods, the patients were divided into study group(n=34, receiving large-sized coil embolization) and control group(n=34, receiving traditional coil embolization). The immediate postoperative Raymond-Roy classification, coil-filling density of aneurysms,consumed amount of spring coils, expense of spring coils, use of intraoperative stent assistance, surgical complications, Glasgow Outcome Score(GOS) at the time of discharge, and postoperative 6-month GOS were compared between the two groups. Results The immediate postoperative Raymond-Roy classification,consumed amount of spring coils, expense of spring coils in the study group were lower than those in the control group, while the coil-filling opacity of aneurysms in the study group was denser than that in the control group, the differences in the above items were statistically significant(P<0.05). No statistically significant differences in the use of intraoperative stent assistance, surgical complications, GOS at the time of discharge,and postoperative 6-month GOS existed between the two groups(P>0.05). Conclusion For the treatment of ICA-PcomA aneurysms, the large-sized coil technique is superior to traditional coil embolization in increasing the coil-filling density of aneurysms and curative rate, in decreasing the recurrence rate of aneurysm, and in reducing the consumed amount of spring coils as well as the expense of spring coils.(J Intervent Radiol,2021, 30: 980-984)