Influencing factors of immediate angiographic results in intracranial aneurysms patients after endovascular treatment

被引:11
作者
Chen, Jia-Xiang [1 ,2 ,3 ]
Lai, Ling-Feng [2 ,3 ]
Zheng, Kuang [2 ,3 ]
Li, Guo-Xiong [2 ,3 ]
He, Xu-Ying [2 ,3 ]
Li, Liang-Ping [2 ,3 ]
Duan, Chuan-Zhi [2 ,3 ]
机构
[1] Jinan Univ, Affiliated Hosp 4, Dept Neurosurg, Guangzhou Red Cross Hosp, Guangzhou, Guangdong, Peoples R China
[2] Southern Med Univ, Zhujiang Hosp, Dept Neurosurg, Guangzhou 510282, Guangdong, Peoples R China
[3] Southern Med Univ, Inst Neurosurg, Key Lab Brain Funct Repair & Regenerat Guangdong, Guangzhou 510200, Guangdong, Peoples R China
关键词
Intracranial aneurysm; Endovascular treatment; Occlusion; UNRUPTURED CEREBRAL ANEURYSMS; SUBARACHNOID HEMORRHAGE; ARTERY ANEURYSMS; NATURAL-HISTORY; MANAGEMENT; STENT; FLOW; COMPLICATIONS; SAFETY;
D O I
10.1007/s00415-015-7824-2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The purpose of this study was to analyze influencing factors associated with immediate angiographic results in intracranial aneurysms patients after endovascular treatment (EVT), providing theoretical evidence and guidance for clinical treatment of intracranial aneurysms. Totally 529 patients met the inclusive criteria, consisting of 338 males and 191 females. Gender; age; history of hypertension, diabetes, and smoking; intracranial atherosclerosis; rupture status, size and location, features of aneurysmal neck, shapes; vasospasm; treatment modality; and degree of aneurysm occlusion were all carefully and completely recorded. All data were investigated in univariate and multivariate logistic regression model to determine whether they were correlated with the degree of aneurysm occlusion. According to aneurysm size, aneurysms were classified as micro-miniature, miniature, and large aneurysms. There were 451 narrow-neck aneurysms and 78 wide-neck aneurysms. Totally 417 were regular and 112 were irregular. And 125 were un-ruptured aneurysms; 404 were ruptured aneurysms. The modalities of treatment were as follows: embolization with coil (n = 415), stent-assisted coil embolization (n = 89), and balloon-assisted coil embolization (n = 25). Univariate analysis showed that aneurysm size, feature of aneurysm neck, shape, and rupture status might affect the immediate occlusion after EVT. Multivariate logistic regression analysis indicated that ruptured aneurysm, tiny aneurysm, and wide-neck aneurysm were independent influencing factors of complete occlusion of intracranial aneurysm. Aneurysm rupture status, size, feature of aneurysmal neck, and shape might be the independent influencing factors of immediate angiographic results in intracranial aneurysm patients after EVT. Un-ruptured, micro-miniature, narrow-neck, and regular-shaped aneurysms were more probable to be occluded completely.
引用
收藏
页码:2115 / 2123
页数:9
相关论文
共 39 条
[1]   PGE2-EP2 signalling in endothelium is activated by haemodynamic stress and induces cerebral aneurysm through an amplifying loop via NF-κB [J].
Aoki, T. ;
Nishimura, M. ;
Matsuoka, T. ;
Yamamoto, K. ;
Furuyashiki, T. ;
Kataoka, H. ;
Kitaoka, S. ;
Ishibashi, R. ;
Ishibazawa, A. ;
Miyamoto, S. ;
Morishita, R. ;
Ando, J. ;
Hashimoto, N. ;
Nozaki, K. ;
Narumiya, S. .
BRITISH JOURNAL OF PHARMACOLOGY, 2011, 163 (06) :1237-1249
[2]   Endovascular Treatment of Very Small (3 mm or Smaller) Intracranial Aneurysms Report of a Consecutive Series and a Meta-Analysis [J].
Brinjikji, Waleed ;
Lanzino, Giuseppe ;
Cloft, Harry J. ;
Rabinstein, Alejandro ;
Kallmes, David F. .
STROKE, 2010, 41 (01) :116-121
[3]   Unruptured Intracranial Aneurysms [J].
Brown, Robert D., Jr. .
SEMINARS IN NEUROLOGY, 2010, 30 (05) :537-544
[4]   Epidemiology and genetics of intracranial aneurysms [J].
Caranci, F. ;
Briganti, F. ;
Cirillo, L. ;
Leonardi, M. ;
Muto, M. .
EUROPEAN JOURNAL OF RADIOLOGY, 2013, 82 (10) :1598-1605
[5]   Predictors of Clinical and Angiographic Outcome After Surgical or Endovascular Therapy of Very Large and Giant Intracranial Aneurysms [J].
Darsaut, Tim E. ;
Darsaut, Nicole M. ;
Chang, Steven D. ;
Silverberg, Gerald D. ;
Shuer, Lawrence M. ;
Tian, Lu ;
Dodd, Robert L. ;
Do, Huy M. ;
Marks, Michael P. ;
Steinberg, Gary K. .
NEUROSURGERY, 2011, 68 (04) :903-915
[6]   Traumatic intracranial aneurysm: A brief review [J].
Dubey, Arvind ;
Sung, Wen-Shan ;
Chen, Yen-Yu ;
Amato, Damian ;
Mujic, Asim ;
Waltes, Pauline ;
Erasmus, Albert ;
Hunn, Andrew .
JOURNAL OF CLINICAL NEUROSCIENCE, 2008, 15 (06) :609-612
[7]   Standard of Practice for the Endovascular Treatment of Thoracic Aortic Aneurysms and Type B Dissections [J].
Fanelli, Fabrizio ;
Dake, Michael D. .
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 2009, 32 (05) :849-860
[8]   Pipeline embolization device (PED) for neurovascular reconstruction: initial experience in the treatment of 101 intracranial aneurysms and dissections [J].
Fischer, Sebastian ;
Vajda, Zsolt ;
Perez, Marta Aguilar ;
Schmid, Elisabeth ;
Hopf, Nikolai ;
Baezner, Hansjoerg ;
Henkes, Hans .
NEURORADIOLOGY, 2012, 54 (04) :369-382
[9]   Saccular intracranial aneurysm: pathology and mechanisms [J].
Frosen, Juhana ;
Tulamo, Riikka ;
Paetau, Anders ;
Laaksamo, Elisa ;
Korja, Miikka ;
Laakso, Aki ;
Niemela, Mika ;
Hernesniemi, Juha .
ACTA NEUROPATHOLOGICA, 2012, 123 (06) :773-786
[10]   Cerebral aneurysm exclusion by CT angiography based on subarachnoid hemorrhage pattern: a retrospective study [J].
Kelliny, Marc ;
Maeder, Philippe ;
Binaghi, Stefano ;
Levivier, Marc ;
Regli, Luca ;
Meuli, Reto .
BMC NEUROLOGY, 2011, 11