中脑膜动脉栓塞中脑膜动脉栓塞的栓塞剂在慢性腹腔内血瘤:一个系统的审查和比较的聚合分析
Helbert de Oliveira Manduca Palmiero1, Eberval Gadelha Figueiredo2
1Department of Neurosurgery, Universidade de São Paulo, São Paulo, Brazil. helbertpalmiero@gmail.com.
Clinical neuroradiology
|December 22, 2025
概括
中脑膜动脉栓塞对于慢性腹腔内血瘤是有效的. 没有单一的栓塞剂显示出一致的优势,在类型之间结果相似.
科学领域:
- 干预性神经放射学 干预性神经放射学
- 神经外科 神经外科
- 血管神经学 血管神经学
背景情况:
- 中脑膜动脉 (MMA) 栓塞是慢性下皮质血瘤 (cSDH) 的一种正在发展中的治疗方法.
- 在cSDH的MMA栓塞中使用的各种栓塞剂的比较有效性尚未得到充分证实.
研究的目的:
- 系统地审查和比较用于MMA栓塞治疗cSDH的不同栓塞剂的有效性.
- 评估与各种栓塞剂相关的治疗失败率,并发症和功能结果.
主要方法:
- 在2025年9月之前对41项研究 (8项元分析,1项范围审查,32个临床队列/系列) 进行系统审查.
- 评估液体剂 (Onyx,Squid,n-BCA),颗粒物 (PVA,微球) 和线圈.
- 主要终点:治疗失败 (复发需要重新干预);次要结果:并发症,死亡率,功能状态.
主要成果:
- 没有任何栓塞剂在研究类型中表现出一致的优越性.
- 聚合的复发率有所不同:n-BCA (0.8%), (3.6%),石 (4.4%),PVA (7.3%),线圈 (9.0%).
- 主要并发症不常见 (1-3%) 并且在各种药物中相似;液体栓塞在没有改善功能结果的情况下更昂贵.
结论:
- MMA栓塞是一种安全有效的cSDH治疗方式.
- 在cSDH中用于MMA栓塞的栓塞剂选择应优先考虑解剖学因素,操作人员技能和资源可用性,而不是特定剂的疗效.
- 通过MMA栓塞治疗cSDH治疗的结果在不同的栓塞剂中通常是可比的.
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