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  • 张小曦,左乔,刘建民,黄清海,许奕,赵瑞,杨鹏飞,洪波.支架辅助弹簧圈栓塞术和单纯弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤安全性的比较[J].第二军医大学学报,2018,39(2):124-128    [点击复制]
  • ZHANG Xiao-xi,ZUO Qiao,LIU Jian-min,HUANG Qing-hai,XU Yi,ZHAO Rui,YANG Peng-fei,HONG Bo.Safety of stent-assisted coiling versus coiling-only in treatment of acute ruptured intracranial wide-necked aneurysms: a comparitive study[J].Acad J Sec Mil Med Univ,2018,39(2):124-128   [点击复制]
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支架辅助弹簧圈栓塞术和单纯弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤安全性的比较
张小曦,左乔,刘建民,黄清海,许奕,赵瑞,杨鹏飞,洪波*
0
(第二军医大学长海医院神经外科, 上海 200433
*通信作者)
摘要:
目的 考察支架辅助弹簧圈栓塞术和单纯弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤的围手术期并发症发生率、病死率,比较两者的安全性。方法 收集2012年1月至2014年12月于第二军医大学长海医院接受支架辅助弹簧圈栓塞术治疗的133例(支架组)和接受单纯弹簧圈栓塞术治疗的289例(单纯栓塞组)急性期颅内破裂宽颈动脉瘤患者的临床资料,通过1:1倾向评分匹配后2组各104例。比较2组的基线资料、围手术期并发症的发生率和病死率。结果 2组基线资料(性别、年龄、动脉瘤位置、与血管的关系、动脉瘤最大径、Hunt-Hess分级和Fisher分级)的差异无统计学意义(P均>0.05)。支架组围手术期出血性并发症、缺血性并发症的发生率和病死率分别为6.7%(7/104)、3.8%(4/104)和1.9%(2/104),单纯栓塞组分别为1.9%(2/104)、1.9%(2/104)、1.0%(1/104),2组比较差异均无统计学意义(χ2=1.858、0.172、0.000,P=0.173、0.679、1.000)。结论 支架辅助弹簧圈栓塞术和单纯弹簧圈栓塞术治疗急性期颅内破裂宽颈动脉瘤均有较高的围手术期安全性,支架的应用不会增加围手术期并发症的发生风险。
关键词:  颅内动脉瘤  破裂  支架  弹簧圈栓塞术  并发症  倾向评分匹配
DOI:10.16781/j.0258-879x.2018.02.0124
投稿时间:2017-11-20修订日期:2017-12-25
基金项目:国家重点研发计划(2016YFC1300700),国家卫生计生委脑卒中防治工程"中国脑卒中高危人群干预适宜技术研究及推广项目"(GN-2016R0012).
Safety of stent-assisted coiling versus coiling-only in treatment of acute ruptured intracranial wide-necked aneurysms: a comparitive study
ZHANG Xiao-xi,ZUO Qiao,LIU Jian-min,HUANG Qing-hai,XU Yi,ZHAO Rui,YANG Peng-fei,HONG Bo*
(Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To compare the peri-procedural complications and mortality between stent-assisted coiling versus coiling-only in the treatment for acute ruptured intracranial wide-necked aneurysms. Methods We retrospectively collected the clinical data of patients with acute ruptured intracranial wide-necked aneurysms who underwent stent-assisted coiling (stent group, n=133) or coiling-only (coiling-only group, n=289) between Jan. 2012 and Dec. 2014 in Changhai Hospital of Second Military Medical University. After 1:1 propensity score matching, 104 cases were matched in each group. Baseline characteristics, peri-procedural complication incidences and mortality were compared between the two groups. Results The baseline characteristics (gender, age, location, relationship with parent vessel, maximum diameter, Hunt-Hess grade and Fisher grade of the aneurysms) were similar in the two groups (all P>0.05). The hemorrhagic and thromboembolic complication incidences and mortality in the stent and coiling-only groups were 6.7% (7/104), 3.8% (4/104) and 1.9% (2/104), and 1.9% (4/104), 1.9% (4/104) and 1.0% (1/104), respectively, and the differences were not statistically significant (χ2=1.858, 0.172, 0.000; P=0.173, 0.679, 1.000). Conclusion The stent-assisted coiling and coiling-only are both safe and feasible for acute ruptured intracranial wide-necked aneurysms. Stents do not increase the risk of peri-procedural complication.
Key words:  intracranial aneurysm  rupture  stents  coiling  complication  propensity score matching