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中间导管的使用与破裂的内动脉瘤的线圈栓塞过程中的手术内破裂有关:一个回顾性倾向得分匹配的研究

Michiyasu Fuga¹, Toshihiro Ishibashi¹, Ken Aoki²

¹Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan.

Frontiers in neurology

|July 29, 2024

概括

在卷轴栓塞过程中使用中间导管 (IMC) 治疗破裂的内动脉瘤 (RIA) 显著增加了手术内破裂 (IPR) 的风险. 为了减轻这种高风险,外科医生在使用IMC时必须更加谨慎.

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:

线圈栓塞是破裂内动脉瘤 (RIA) 的首要治疗方法.
在此过程中使用中间导管 (IMC) 可能会增加由于对微导管和线圈的直接压力而导致程序内破裂 (IPR) 的风险.

研究的目的:

调查使用中间导管 (IMC) 和在破裂内动脉瘤 (RIAs) 线圈栓塞期间的程序内破裂 (IPR) 率之间的相关性.

主要方法:

对192名因囊性RIA治疗的患者中的195个动脉瘤进行了回顾性审查.
患者被分为使用IMC (IMC组) 和不使用IMC (非IMC组) 的组.
进行了倾向性得分匹配分析,以控制各种临床和程序因素.

主要成果:

在单变量分析中,使用IMC的病例中有14.0%发生了过程内破裂 (IPR),而没有IMC的病例为3.3% (p=0.016).
在倾向分数匹配后,IMC组的IPR发病率仍然显著高 (23.1%对3.8%,p=0.015).
两组之间没有发现缺血并发症或与IMC相关的母动脉剖析的显著差异.

结论:

中间导管 (IMC) 的使用与破裂内动脉瘤 (RIA) 线圈栓塞期间的手术内破裂 (IPR) 发生率显著增加有关.
神经外科医生和干预放射科医生应在RIA治疗中使用IMC时保持高度警和细致的技术,以尽量减少IPR风险.

关键词:

气球导导管导管是指导气球的导管.远距离接入导管.血管内治疗血管内治疗发生出血并发症.在手术内发生动脉瘤破裂.在手术期间出现的并发症.在手术内发生破裂.脑下关节下部出血

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