用管道栓塞装置治疗中型至巨型内动脉瘤的卷积栓塞策略:一种倾向性得分加权的研究
Xin Tong1, Mingyang Han2, Xiaopeng Xue1
1Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
European radiology
|June 14, 2023
概括
将线圈添加到动脉瘤管道栓塞装置 (PED) 治疗中可以改善阻塞,但会增加风险和成本. 密集包装与松散包装没有任何额外的好处,只有更高的费用.
科学领域:
- 内血管神经外科手术 血管内血管神经外科
- 脑血管疾病管理的管理
背景情况:
- 管道栓塞装置 (PED) 用于动脉瘤.
- 线圈栓塞是一种辅助策略.
研究的目的:
- 调查不同线圈策略和PED治疗动脉瘤的结果之间的关联.
- 为了比较单独的PED与带有卷轴的PED (松散与密集的包装).
主要方法:
- 对398名患有PED治疗的410例动脉瘤的患者进行了回顾性分析.
- 分为单独PED和PED卷轴组 (松散包装与密集包装).
- 多变量后勤分析,稳定治疗权重的逆概率 (sIPTW) 和受限立方线 (RCS) 曲线.
主要成果:
- 与单独使用PED相比,PED线圈的不完全封闭率较低 (15.3%与30.3%相比),但并发症较高 (14.2%与3.5%相比),手术时间更长,成本增加.
- 松散包装和密集包装之间没有显著的结果差异,尽管密集包装更昂贵.
- RCS曲线显示了线圈度与结果之间的"L形"关系.
结论:
- PED卷轴可以改善动脉瘤堵塞,但会增加并发症,手术时间和成本.
- 密集包装不会比松散包装提高效率,而且会增加成本.
- 在某个特定点 (例如, >3个线圈或>150厘米长度) 之后,最优的线圈栓塞效应高原.
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