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对前动脉瘤内血管治疗方法的比较分析:80个动脉瘤的单中心研究

Yigit Can Senol^1,2, Halis Emre Ciftci³, Zeynep Gence Oz³

¹Department of Neurosurgery, University of California San Francisco, San Francisco, CA, USA. yigitcan.senol@ucsf.edu.

Acta neurochirurgica

|September 1, 2025

概括

与初级卷轴相比,支架辅助卷轴 (SAC) 和流量转移 (FD) 提供了较高的前动脉瘤 (AChoA) 阻塞率. 治疗选择应考虑动脉瘤形态和患者的风险因素以获得最佳结果.

科学领域:

神经内血管外科
脑血管疾病管理
干预性神经放射学

背景情况:

前动脉 (AChoA) 动脉瘤是罕见的,并且由于动脉的小尺寸和关键位置而难以治疗.
内血管治疗 (EVT) 是一种首选的方法,但最佳技术需要进一步研究.

研究的目的:

对AChoA动脉瘤进行不同EVT技术的疗效和安全性进行比较.
在治疗这些动脉瘤时评估初级卷曲,支架辅助卷曲 (SAC) 和流量转移 (FD).

主要方法:

用EVT治疗的60名80名AChoA动脉瘤患者的回顾性分析.
根据EVT技术,动脉瘤形态 (依赖或独立) 和破裂状态进行分类.
血管学阻塞的评估 (雷蒙德- 罗伊阻塞量表) 和临床结果 (修改的兰金量表).

主要成果:

在SAC (83. 3%) 和FD (76. 1%) 观察到较高的完全闭塞率,而不是初级卷曲 (31. 8%) (p<0. 05).
有更多的技术并发症 (25%),依赖性动脉瘤有更多的缺血事件 (p<0.05).
在FD后没有出现症状的AChoA封闭;死亡率为5% (所有患者都属于破裂动脉瘤的初级卷曲组).

结论:

对于AChoA动脉瘤,EVT是有效的,SAC和FD显示出比初级卷轴更好的闭塞率.
FD具有更高的技术并发症风险,但保留了AChoA的通透性.
根据动脉瘤形态和患者因素定制EVT选择对于优化治疗结果至关重要.

关键词:

动脉瘤前胸动脉内血管疾病

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