线圈栓塞的长期结果对于上下垂体动脉动脉瘤的治疗
Yan-Po Kang1, Cheng-Yu Li1, Chun-Ting Chen1
1Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Frontiers in neurology
|July 17, 2023
概括
对于上下细胞动脉动脉瘤的内血管治疗是有效的,在使用支架辅助卷轴时,复发率较低. 破裂动脉瘤和非支架技术增加了复发风险,但支架的使用可以防止复发.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
- 血管神经学 血管神经学
背景情况:
- 上下垂体动脉 (SHA) 动脉瘤由于其位置而具有挑战性,难以通过手术治疗.
- 内血管治疗 (EVT) 首选用于SHA动脉瘤,但长期结果需要进一步调查.
- 破裂的SHA动脉瘤可能导致下大脑关节出血,需要有效的治疗策略.
研究的目的:
- 评估EVT后SHA动脉瘤复发的发生率和风险因素.
- 为了确定与SHA动脉瘤破裂相关的因素.
- 评估重新治疗的必要性和进一步干预的有效性.
主要方法:
- 对112名用EVT治疗的SHA动脉瘤患者的回顾性分析 (2009-2020年).
- EVT的模式包括非支架辅助 (简单/气球辅助) 或支架辅助的卷轴.
- 使用后勤回归分析来确定破裂,复发和重新治疗的风险因素.
主要成果:
- 类型IA或IB洞穴内动脉 (cICA) 与SHA动脉瘤破裂有关.
- 复发发生在13.4%的患者中,主要是在EVT后2年内.
- 破裂的动脉瘤和非支架辅助的线圈是复发的独立风险因素;支架辅助的线圈防止了复发.
结论:
- 线圈栓塞是SHA动脉瘤的有效EVT,复发率低,特别是在支架辅助的情况下.
- 以前的动脉瘤破裂和非支架技术与复发的增加有关.
- 支架辅助线圈对于防止SHA动脉瘤复发至关重要.
相关概念视频
Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10
Aneurysm III: Interprofessional Care
10
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
10
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
202
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
202
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8


