靠近前脑动脉动脉瘤的手术与内血管治疗:一个元分析
Zongqi You1, Yaoxian Xiang1, Junxi Dai1
1Key Laboratory of Peripheral Nerve and Microsurgery, Huashan Hospital, Fudan University, Shanghai, China.
Neurology India
|May 31, 2024
概括
靠近前脑动脉 (PACA) 动脉瘤的内血管治疗显示出比手术更好的结果和更少的并发症. 对于破裂的PACA动脉瘤,手术仍然是首选的,这凸显了手术前评估的重要性.
科学领域:
- 神经外科 神经外科
- 干预神经病学 干预神经病学
- 血管神经学 血管神经学
背景情况:
- 靠近前脑动脉 (PACA) 动脉瘤是罕见的 (<1%的内动脉瘤).
- 这些动脉瘤由于大小,底部,壁壁脆弱性和相关的血管异常而带来了手术挑战.
- 对PACA动脉瘤的最佳治疗策略仍在外科手术和内血管方法之间进行辩论.
研究的目的:
- 系统地审查和对PACA动脉瘤的治疗策略进行元分析.
- 为了比较PACA动脉瘤手术与内血管干预的疗效和安全性.
主要方法:
- 在科克伦图书馆,EMBASE,PubMed和科学网络 (2000-2020) 的系统文献搜索.
- 包括回顾性研究,调查PACA动脉瘤的手术和/或内血管治疗.
- 来自19项涉及358名患者 (150名外科,208名内血管) 的研究数据的元分析.
主要成果:
- 内血管治疗组在出院和随访时的临床结果明显更好.
- 在手术和内血管组之间,与手术相关的发病率没有显著差异.
- 与手术相关的死亡率在内血管组 (1%) 与手术组 (8.7%) 相比显著较低.
结论:
- 内血管治疗对于在PACA动脉瘤中获得有利的临床结果来说更安全,更有效.
- 手术仍然是破裂PACA动脉瘤的首选方法.
- 彻底的手术前评估对于确定最佳治疗策略至关重要.
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