对未破裂的内动脉瘤中手术内破裂的预测因素和后果的元分析洞察
Mustafa Ismail1, Norito Kinjo2, Imad Samman Tahhan2
1Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, 29403, USA. mustafalorance2233@gmail.com.
Neurosurgical review
|September 12, 2025
概括
在未破裂的大脑动脉瘤的内血管治疗期间的程序性破裂是罕见但严重的. 老年人,高血压妇女与不规则的前部通讯动脉动脉瘤是最有风险的,简单的卷曲构成更高的危险.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
- 血管神经学 血管神经学
背景情况:
- 程序内破裂 (IPR) 是在未破裂的内动脉瘤的内血管治疗 (EVT) 期间的一种严重并发症.
- 了解知识产权预测因素和结果对于提高患者安全至关重要.
研究的目的:
- 系统地评估预测因素,程序性风险因素和IPR在未破裂的内动脉瘤中的临床结果.
- 通过元分析来综合现有证据.
主要方法:
- 按照PRISMA 2020指南,对PubMed和Scopus进行系统的文献搜索.
- 11项回顾性研究的元分析,其中包括11,081个未破裂的动脉瘤.
- 使用随机效应模型,对风险因素,程序特征和临床结果进行聚合分析.
主要成果:
- IPR的总体发病率约为6.4%.
- 预测因素包括晚年 (≥60岁),女性性别,高血压,不规则动脉瘤形态和前沟通动脉位置.
- 与其他技术相比,简单的卷轴与更高的IPR率有关;与流量转移器没有观察到IPR事件.
结论:
- IPR是EVT中未破裂动脉瘤的罕见但显著的并发症,特别是在具有特定动脉瘤特征的老年高血压女性中.
- 流量转移器可能提供一种更安全的替代方案,而不是简单的卷轴.
- 有针对性的预防策略对于减轻知识产权风险至关重要.
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