中脑膜动脉栓塞可以减少隔膜性慢性腹腔内血瘤手术后的复发
Juan Carlos Martinez-Gutierrez1, Bryden H Dawes1, Hussein A Zeineddine1
1Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Clinical neurology and neurosurgery
|March 24, 2024
概括
中脑膜动脉栓塞 (MMAE) 在与手术疏散一起使用时,可显著降低隔膜性慢性腹腔内血瘤 (cSDH) 的重新手术和复发率. 这种辅助疗法在预防cSDH复发方面表现出很高的有效性.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
- 血管外科 血管外科
背景情况:
- 在手术疏散后,七度性慢性腹膜下血瘤 (cSDH) 经常复发.
- 中脑膜动脉栓塞 (MMAE) 是一种潜在的辅助疗法,用于预防cSDH复发.
- 作为cSDH手术的辅助,MMAE的疗效需要进一步定义.
研究的目的:
- 评估MMAE作为辅助疗法的有效性,用于隔离cSDH患者的二次预防.
- 为了比较仅用手术治疗的患者与手术加MMAE治疗的患者之间的再手术和复发率.
主要方法:
- 对在机构治疗的隔膜cSDH病例的回顾性审查.
- 仅手术组 (2018年之前) 与手术加MMAE组 (2018年之后) 的比较.
- 主要结果:重新运行率. 二次结果:复发,血瘤厚度,中线移动.
主要成果:
- 在28名患者中分析了34个cSDH (手术+MMAE) 和在83名患者中分析了95个cSDH (仅手术).
- 两组之间没有观察到显著的基线差异.
- 仅进行手术的组与手术+MMAE组 (0.0%) (p=0.006) 相比,仅进行手术的组的复手率显著更高 (16.8%).
- 手术+MMAE组显示复发的发生率显著降低 (p=0.011).
结论:
- 在预防隔膜cSDH的复发和重新手术方面,MMAE非常有效.
- 对于这种患者群体来说,MMAE是外科疏散的有益补充.
- 这种方法提供了一种有前途的策略,用于改善cSDH管理的结果.
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