フローダイバーター治療における最適なコイル充填密度：網膜洞完全閉塞を目指した後向き研究
Ryosuke Maeoka1,2, Hiroyuki Ohnishi2, Shohei Yokoyama1
1Department of Neurosurgery Nara Medical University Nara Japan.
Stroke (Hoboken, N.J.)
|January 23, 2026
まとめ
大型脳動脈瘤におけるフローダイバーターおよびコイル塞栓術の最適な充填密度（PD）は8.9%である可能性がある。このPDを達成することで完全閉塞が得られ、不必要なコイル塞栓術を減らすことができる可能性がある。
科学分野:
- Neurosurgery
- Interventional Radiology
- Vascular Neurology
背景:
- Flow diverter stent (FDS) deployment combined with coil embolization (CE) is effective for treating cerebral aneurysms.
- Optimal packing density (PD) for FDS and CE in large or giant aneurysms remains undefined.
- This study investigates the ideal PD for maximizing treatment efficacy.
研究 の 目的:
- To determine the optimal packing density (PD) for flow diverter stent (FDS) deployment with coil embolization (CE).
- To assess the association between PD and complete obliteration (CO) in large or giant intracranial aneurysms.
主な方法:
- Retrospective multicenter study of 97 patients with large/giant unruptured aneurysms treated with FDS alone or FDS + CE.
- Coil PD calculated as volume embolization ratio; complete obliteration defined by O'key-Marotta grading scale D at 6 months.
- Analysis of associations between PD and CO using univariable and multivariable models.
主要な成果:
- A volume embolization ratio (PD) of ≥ 8.9% was significantly associated with complete obliteration (CO).
- Higher PD showed a strong correlation with CO in both univariable (OR 14.3) and multivariable (OR 10.5) analyses.
- While the FDS + CE group showed higher CO rates (82.3% vs 50.0%), the key finding was the PD threshold.
結論:
- A packing density of 8.9% volume embolization ratio may be sufficient for achieving complete obliteration in large or giant intracranial aneurysms treated with FDS + CE.
- Further coil embolization beyond this threshold may not be necessary, potentially streamlining the procedure.
- This finding could guide clinical decision-making for optimizing FDS and CE treatment strategies.
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