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中华神经外科疾病研究杂志 2015年第1期14卷 11-11页

作者： Konczalla J Platz J Brawanski N Güresir E Lescher S Senft C du mesnil de rochemont r Berkefeld J Seifert V

BACKGrOUND Aneurysms of the internal carotid artery(ICA)bifurcation are rare,and no studies have compared patient outcomes after endovascular vs surgical *** To report the safety,efficacy,and follow-up outcome of these 2treatment options for patients with ICA bifurcation *** Patient and aneurysm characteristics,treatment results,and follow-up outcomes(at 30 months)were analyzed from patient records and review of imaging *** A total of 58 patients with ICA bifurcation aneurysms were *** interdisciplinary consensus,30 aneurysms were assigned for coiling and 28 for *** who underwent surgical clipping were younger and had larger *** patients were assigned to coiling if their aneurysms originated only from the ICA bifurcation or projected *** the combined angiographic endpoint,complete and nearly complete occlusion(raymond-roy I+II),similar rates of 96%(coiling)or 100%(clipping)could be ***-roy I occlusion occurred more often after clipping(79%vs 41%coiling).Follow-up of the endovascular group showed minor recanalization of the aneurysm neck(raymond-roy II)in 42%.One patient(4%)showed a major recanalization(raymond-roy III)and needed *** incidental findings,no bleeding complications or new persistent neurological deficits occurred during *** Treatment of ICA bifurcation aneurysms after interdisciplinary assignment to clipping or coiling is effective and *** significantly more minor recanalizations after coiling,the re-treatment rate was very low,and no bleeding was observed during *** analysis revealed that origin only from the ICA bifurcation was an independent predictor of aneurysm recanalization after endovascular treatment.

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