在未破裂动脉瘤中部署转流器后延迟动脉瘤破裂:系统性审查和元分析
Fernanda Rodriguez-Erazú1,2, Abdelrahman M Hamouda3, Sherief Ghozy3,4
1Lyerly Neurosurgery, Baptist Medical Center Downtown, Jacksonville, Florida, USA.
Journal of neurointerventional surgery
|December 3, 2025
概括
在流量转移器 (FD) 治疗后延迟动脉瘤破裂 (DAR) 是罕见但严重的. 大型动脉瘤大小,动脉瘤内血栓和后部循环位置是关键的危险因素,大多数事件发生在30天内.
科学领域:
- 神经内血管外科手术是一种神经内血管手术.
- 脑血管疾病是脑血管疾病.
- 医疗器械技术 医疗器械技术
背景情况:
- 延迟动脉瘤破裂 (DAR) 是流转器 (FD) 放置后的一种严重并发症.
- 对于DAR的精确机制和预测因素仍然不完全理解.
- 目前的证据需要综合,以告知临床实践和未来的研究.
研究的目的:
- 在FD治疗后对DAR进行现有文献进行元分析.
- 确定与DAR发生相关的重大风险因素.
- 为了确定DAR在FD后部署的综合流行率和时间.
主要方法:
- 系统审查和对2024年6月之前发表的研究进行元分析.
- 在主要的生物医学数据库 (PubMed,Scopus,Web of Science,Embase) 进行的搜索.
- 纳入标准:报告DAR的研究>5名患者;使用R软件进行分析.
主要成果:
- 分析了包括9820名患者在内的64项研究.
- 严重的DAR风险因素包括大动脉瘤大小,动脉瘤内血栓和后部循环位置.
- 聚合DAR患病率为1.40% (1.18%不包括异常值),其中66.7%发生在30天内,死亡率为73.3%.
结论:
- DAR后FD是一种罕见但毁灭性的并发症,限制了该技术的实用性.
- 确定了预测因素,需要仔细选择和监测患者.
- 早期的程序后期 (前30天) 是关键的,强调需要改进风险评估和管理策略.
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