Complications associated with stent-assisted coil embolization of wide-neck intracranial aneurysms / 中国组织工程研究
Chinese Journal of Tissue Engineering Research
;
(53): 5506-5512, 2017.
Article
Dans Chinois
| WPRIM
| ID: wpr-665404
ABSTRACT
BACKGROUND:
Stent-assisted coil embolization has become an important technique for the treatment of intracranial complex aneurysms. However, there is no systematic analysis of complications and prevention strategies related to this technique.OBJECTIVE:
To systematically analyze the complications related to stent-assisted coil embolization of intracranial aneurysms during perioperative and follow-up periods and to assess the safety of this method.METHODS:
A retrospective study of 232 consecutive patients with 239 wide-necked aneurysms who underwent stent-assisted coil embolization at the Department of Neurosurgery, General Hospital of Shenyang Military Command from July 2003 to December 2009 was performed. Angiographic results and clinical outcomes were evaluated. A variety of complications were analyzed. The technical feasibility of the procedure, procedure-related complications, angiographic results, clinical outcomes and follow-up angiography were evaluated. RESULTS ANDCONCLUSION:
Stenting was successful in the 236 of 239 aneurysms. Procedure-related complications included thomboembolism (n=13), intraprocedural rupture (n=8), coil protrusions (n=5), new mass effect (n=3), vessel injury (n=3), and stent dislodgement (n=2). Procedure-related morbidity and mortality was 4.3% (10/232) and 1.3% (3/232), respectively. Nonprocedural complications attributable to subarachnoid hemorrhage in 129 patients with acute ruptured aneurysms were symptomatic vasospasm (18.6%, 24/129) and shunt-dependent hydrocephalus (7.0%, 9/129). Favorable clinical outcomes (mRS 0-2) were observed in 88.3% (205/232) of the patients, and no rehemorrhage of treated aneurysms occurred. Follow-up angiography was obtained in 155 patients (159 treated aneurysms). The overall recanalization rate was 14.5% (23/159). No stenting or coiling displacement occurred during the follow-up. Delayed complications included in-stent stenosis (n=2) and penetrating artery occlusion (n=2). In conclusion, our study indicates that stent-assisted coil embolization of intracranial aneurysm is a safe technique with low morbidity and mortality rates. Thromboembolism is the main cause of procedure-related disability and death. Nevertheless, further long-term follow-up is necessary to determine the durability of these promising results.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Type d'étude:
Étude observationnelle
langue:
Chinois
Texte intégral:
Chinese Journal of Tissue Engineering Research
Année:
2017
Type:
Article
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