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大型和巨型内动脉瘤的流量转移与卷积:系统性审查和元分析

Matteo Scalise¹, Leonardo Di Cosmo², Carlo Cossa²

¹Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.

Journal of clinical medicine

|February 27, 2026

概括

与卷曲相比,流量转移 (FD) 显著减少了大型内动脉瘤的复发,具有类似的安全性,但出血风险略高. FD正在成为未破裂动脉瘤的首选选择.

科学领域:

神经外科神经外科
干预神经病学干预神经病学
血管神经学血管神经学

背景情况:

大型 (≥10毫米) 和巨型 (≥25毫米) 内动脉瘤由于破裂的高风险和程序的复杂性而带来了重大管理挑战.
像流量转移 (FD) 这样的内血管方法提供了希望,但对传统卷轴的安全性和有效性的比较数据有限.

研究的目的:

为了比较流量转移 (FD) 与卷轴的安全性和有效性,用于治疗大和巨大的内动脉瘤.
评估结果,包括动脉瘤复发,闭塞率,临床结果和并发症.

主要方法:

一个系统的审查和元分析,遵循PRISMA指南.
包括2000年1月至2025年3月期间从主要数据库 (PubMed,EMBASE,Scopus,Web of Science) 发表的研究.
评估结果如复发,完全封闭,临床结果,并发症和死亡率,计算几率比率 (ORs) 与95%置信区间 (CI).

主要成果:

该分析包括33项研究中的1893名患者 (1256名FD,637名Coiling).
与线圈相比,流量转移显著减少了动脉瘤复发 (8%对27%,p=0.0001),并显示出更高的完全闭塞率 (p=0.0571) 的趋势.
流量转移与出血并发症的适度增加率相关 (p=0.0495),其他主要并发症,临床结果或死亡率没有显著差异.

结论:

在大/巨大的内动脉瘤中,FD和卷积都是有效和安全的.
FD显示出更高的复发率和更好的闭塞趋势,具有相似的整体安全性,但略有增加的出血风险.
FD正在成为未破裂的大型和巨型动脉瘤的首选一线治疗方法,而卷积对于破裂病例或解剖学限制至关重要.

关键词:

卷轴绕卷轴绕在线流量转移流量转移流量转移巨大的内动脉瘤.内动脉瘤是什么?大型的内动脉瘤.

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