RESUMO
Objective To compare the recurrence rate and long-term follow-up angiographic findings between stent-assisted coil embolization and simple coil embolization in treating large and giant intracranial aneurysms.Methods The clinical data and imaging materials of a total of 90 patients with large and giant intracranial aneurysms (＞10 mm,91 aneurysms in total),who were admitted to authors' hospital during the period from January 2004 to January 2016 to receive interventional embolization therapy,were retrospectively analyzed.Of the 90 patients,52 patients (52 lesions in total) received simple coil embolization (SCE group)and 38 patients (39 lesions in total) received stent-assisted coil embolization (SACE group).Postoperative recurrence rates of aneurysm were compared between the two groups,and recurrence risk factors were analyzed.Results The whole postoperative recurrence rate of aneurysm and re-treatment rate were 38.5％(35/91) and 20.9％(19/91) respectively;the recurrence rate and re-treatment rate of SACE group were 35.9％ (14/39) and 17.9％ (7/39) respectively,while those of SCE group were 40.4％ (21/52) and 23.1％ (12/52) respectively;the differences between the two groups were not statistically significant (P＞0.05).Multivariate logistic regression indicated that the recurrence risk factors of large or giant intracranial aneurysms included rupture of aneurysm (OR=0.284,95％CI=0.083-0.978,P=0.046),simple coil embolization (OR=5.03,95％ CI=1.04-24.44,P=0.045),concurrent hypertension (OR =0.13,95％ CI=0.036-0.51,P=0.003)and long time after operation (OR=1.002,95％CI=1.001-1.003,P=0.002).Conclusion Compared with simple coil embolization,stent-assisted coil embolization can reduce the recurrence rate of aneurysm.Rupture of aneurysm,simple coil embolization,long time after operation and concurrent hypertension are independent risk factors for recurrence of aneurysm after transcatheter arterial embolization.
RESUMO
Objective To present our preliminary experience and short-term safety and efficacy of pipeline embolization device (PED) for endovascular of intracranial aneurysms.Methods Six patients treated with PED in our hospital from February 2016 to June 2016 were chosen.Their clinical data and short-term safety and efficacy were retrospectively analyzed.Results Six patients with 6 intracranial aneurysms were treated during the study period.Mean aneurysm size was 18.3±9.2 mm.PED was technically successful in all aneurysms (100％).A total of 8 PEDs were used,and the mean number of devices per aneurysm was 1.3.Treatment was achieved with one single PED in 5 aneurysms,with 3 overlapping PEDs in one aneurysm.Adjunctive coiling was performed in 3 aneurysms.Retention of contrast agent in the tumor cavity was detected by immediate radiography:Kamran grade Ⅰ was noted in 4 patients and grade Ⅱ in 2 patients.No procedure-related complications occurred.Five patients achieved good clinical outcome (mRS score 0 in 2 patients,one in 3 patients and 3 in one patient).MRA was performed in 5 patients 3 months after surgery,indicating no arterial aneurysm residual and far-endvascular patency;and one of these 5 patients was performed DSA showing no arterial aneurysm relapse.Conclusions In our series,early results of the PED are encouraging.However,larger studies with longer follow-up duration are warranted to assess the safety and efficacy of PED for treating intracranial aneurysms.