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Progressive Occlusion of Enterprise Stent-Assisted Coiling of Ruptured Wide-Necked Intracranial Aneurysms and Related Factors on Angiographic Follow-Up: A Single-Center Experience with 468 Patients
被引:18
作者:
Peng, Tangming
[1
]
Qian, Zenghui
[1
]
Liu, Aihua
[1
]
Li, Youxiang
[1
]
Jiang, Chuhan
[1
]
Wu, Zhongxue
[1
]
机构:
[1] Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, Beijing, Peoples R China
来源:
PLOS ONE
|
2014年
/
9卷
/
03期
基金:
中国国家自然科学基金;
关键词:
ENDOVASCULAR TREATMENT;
EMBOLIZATION;
NEUROFORM;
D O I:
10.1371/journal.pone.0092407
中图分类号:
O [数理科学和化学];
P [天文学、地球科学];
Q [生物科学];
N [自然科学总论];
学科分类号:
07 ;
0710 ;
09 ;
摘要:
This study was designed to assess the effect of the Enterprise stent on progressive occlusion of wide-necked aneurysms and to evaluate the association between dubious factors and progressive occlusion, which is a consecutive, retrospective, single-center study. Data from 468 patients with 495 wide-necked aneurysms, who had undergone Enterprise stent-assisted coiling (SAC) were reviewed, and the clinical outcomes and the angiographic results were analyzed. A 14-month clinical follow-up was achieved in 421 of the 468 patients (90.0%), showing modified Rankin Scale (mRS) 0-1 in 364 (86.4%), mRS 2 in 17 (4.1%), mRS 3 in 17 (4.1%), mRS 4-5 in 9 (2.1%), and mRS 6 in 14 (3.3%) patients. Overall, the morbidity and mortality were 10.2% and 3.3%, respectively. Initial angiographic results showed Raymond scale (RS) 1 in 273 (55.2%), RS2 in 194 (39.2%), and RS3 in 28 (5.6%) patients. Eight-month angiographic follow-up was available in 394 of 495 patients (79.6%), and RS1 was seen in 315 (79.9%), RS2 in 65 (16.5%) and RS3 in 14 (3.6%) cases. At the end of the follow-up, 115 of the 165 (69.7%) patients with initial RS2 and RS3 showed progressive occlusion. Statistical analysis showed no significant difference between progressive occlusion and age (p = 0.654), sex (p = 0.016), aneurysm diameter (p = 0.010), neck size (p = 0.124), dome-to neck ratio (DNR) (p = 0.018) and location (p = 0.001) at the time of follow-up. SAC using Enterprise stent is not only feasible for wide-necked aneurysms, but can achieve a high rate of progressive occlusion with good clinical outcomes at medium-term follow-up. Patient age and aneurysm neck size showed no associated with progressive occlusion at follow-up, while sex, aneurysm diameter, DNR and location were significantly associated with progressive occlusion.
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