与Moyamoya相关的内动脉瘤的内血管治疗:系统性审查和元分析
Mariana Letícia de Bastos Maximiano1, Ocílio Ribeiro Gonçalves2, Pedro Lucas Machado Magalhães3
1Federal Fluminense University, Niterói, Brazil marianabastosmaximiano@gmail.com.
Journal of neurointerventional surgery
|August 11, 2025
概括
内血管治疗 (EVT) 是对莫亚莫亚病相关的内动脉瘤 (MMD-IA) 的安全有效的选择,显示出高闭塞率和良好的功能结果. 由于动脉瘤复发的风险,长期监测至关重要.
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:
- 莫亚莫亚病 (MMD) 涉及脑动脉的渐进性狭窄,增加了动脉瘤风险.
- 与MMD相关的内动脉瘤 (MMD-IA) 带来了重大的临床挑战.
- 对MMD-IA的内血管治疗 (EVT) 的作用需要进一步澄清.
研究的目的:
- 系统地审查和进行关于EVT对MMD-IA的安全性和有效性的元分析.
- 评估MMD-IA患者的功能性结果和与EVT相关的并发症率.
- 评估MMD-IA的EVT后的长期结果,包括动脉瘤复发.
主要方法:
- 按照PRISMA指南,在主要数据库 (PubMed,Embase,Web of Science) 进行全面的文献搜索.
- 包括17项研究,包括506名被诊断为MMD-IA的患者,重点是接受EVT治疗的患者.
- 使用随机效应模型对完全闭塞率,功能独立性 (mRS 0-2),程序性并发症和复发率的聚合分析.
主要成果:
- 在手术后,EVT的综合完全闭塞率为86.46%,在最后一次随访时为84.51%.
- 与手术相关的并发症发生在15.27%的病例中,甲状腺下出血发生在5.25%,缺血性并发症发生在8.69%.
- 86.93%的患者实现了功能独立,而动脉瘤复发率为8.08%.
结论:
- EVT在治疗MMD-IA方面显示出安全性和有效性,具有高闭塞率和有利的功能结果.
- 观察到的复发率强调了需要勤奋长期监测患者的必要性.
- 需要进一步进行广泛的研究来巩固这些发现,并完善MMD-IA的EVT策略.
关键词:
动脉瘤是一个动脉瘤.相关概念视频
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