合并同侧胚胎型大脑后动脉的后交通动脉动脉瘤栓塞术后复发的影响因素分析

Risk factors of aneurysm recurrence of parents with posterior communicating artery aneurysm associated with ipsilateral fetal posterior cerebral artery after endovascular embolization

目的探讨合并同侧胚胎型大脑后动脉(fPCA)的后交通动脉动脉瘤(PCoAA)血管内栓塞术后复发的危险因素。方法回顾性分析2015年1月至2021年1月血管内栓塞治疗的68例合并同侧fPCA的PCoAA的临床资料。术后6个月复查DSA或320-CTA判断动脉瘤复发。结果68例中,术后复发22例,未复发46例;术后复发率为32.4%(22/68)。多因素logistic回归分析显示,单纯弹簧圈栓塞(OR=10.393;95%CI 1.715~62.967;P=0.011)、术后即刻不完全栓塞(OR=12.097;95%CI 2.644~55.354;P=0.001)是术后复发的独立危险因素。结论合并同侧fPCA的PCoAA血管内栓塞术后复发率较高,单纯弹簧圈栓塞、术后即刻不完全栓塞病人术后复发率风险高,需要更为密切的随访。

Objective To analyze the risk factors for aneurysm recurrence of parents with posterior communicating artery aneurysm(PCoAA)associated with ipsilateral fetal posterior cerebral artery(fPCA)after endovascular embolization.Methods The clinical data of 68 patients with PcoAA assocaited ipsilateral fPCA who received endovascular therapy from January 2015 to January 2021 were retrospectively analyzed.The recurrence of aneurysm was determined by DSA or 320-CTA 6 months after surgery.Results Aneurysm recurrence occurred in 22 patients and did not occur in 46 patients.The rate of aneurysm recurrence was 32.4%(22/68).Multivariate logistic regression analysis showed that simple embolisation with coils(OR=10.393;95%CI 1.715~62.967;P=0.011)and incomplete embolization(OR=12.097;95%CI 2.644~55.354;P=0.001)were independent risk factors for aneurysm recurrence.Conclusions The recurrence rate of PCoAA associated with ipsilateral fPCA is high after endovascular embolization.Close follow-up is recommended in the patients who receive simple coil embolization or incomplete embolization because they have a higher risk of recurrence.