前胸动脉动脉瘤的内血管结局:系统性审查和元分析
Yigit Can Senol1, Atakan Orscelik2, Basel Musmar3
1Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
概括
前胸动脉 (AchoA) 动脉瘤的内血管治疗显示出高的成功率和低的并发症率. 线圈和流量转向器都是有效的,但2型AchoA动脉瘤和破裂动脉瘤的风险更高.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 干预性放射学 干预性放射学
背景情况:
- 前冠状动脉 (AchoA) 动脉瘤是一种罕见的脑血管病变.
- 内血管治疗 (EVT) 携带胆道动脉封闭的风险.
- 研究EVT对AchoA动脉瘤的安全性和有效性至关重要.
研究的目的:
- 评估对AchoA动脉瘤的内血管治疗的安全性和有效性.
- 分析与AchoA动脉瘤的EVT相关的并发症率.
- 为了比较不同EVT模式和动脉瘤类型的结果.
主要方法:
- 对10项涉及416名患者和430名AchoA动脉瘤的研究进行了系统审查和元分析.
- 主要结局:血管图和临床结果.
- 二次结局:缺血性并发症,闭塞,再治疗率;根据动脉瘤类型,破裂状态和治疗方式 (卷轴与流量转移器) 的子组分析.
主要成果:
- 高整体良好的临床结果率 (94.5%) 和低的再治疗率 (2.0%).
- 卷轴和流量转移器显示了类似的完全封闭率 (75.3%和80.9%).
- 低的永久性 (1.4%) 和短暂的 (4.2%) 缺血性并发症率. 2型动脉瘤 (9.8%) 和破裂动脉瘤的并发症发生率明显更高.
结论:
- 内血管治疗是阿乔A动脉瘤的安全有效选择.
- 卷轴和流量转向器提供可比的阻塞结果.
- 动脉瘤破裂和2型解剖学增加并发症的风险,需要仔细考虑.
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