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Angiographic follow-up of cerebral aneurysms treated with Guglielmi detachable coils(GDCs): An analysis of 162 cases of 173 aneurysms

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介入放射学杂志 2005年第5期14卷 472-479页

作者： LI Ming-hua GAO Bu-lang FANG Chun GU Bin-xian CHENG Ying-sheng WANG Wu Giuseppe Scotti Department of Diagnostic and Interventional Radiology Shanghai Sixth People＇s Hospital Affiliated to Shanghai Jiao Tong University Shanghai 200233 P.R. China Department of Neurosurgery Shanghai Sixth People＇s Hospital Affiliated to Shanghai Jiao Tong University Shanghai 200233 P.R. China Departmentof Neuroradiology San Laffaele Hospital Milano Italy

Objective To evaluate the mid- and long-term radiological outcomes of cerebral aneurysms with GDCs *** One hundred and sixty-two patients with 173 aneurysms embolized with GDCs underwent angiographic follow-up from 1 to 54 months post-operatively and were retrospectively reviewed. Three neuro-radiologists reviewed each angiogram and made a comparison between initial and follow-up angiograms. Morphological outcomes were evaluated as follows: unchanged; progressive thrombosis; and re-opening or re-growth. Results Of 173 aneurysms with GDC embolization, 142 aneutysms had total or nearly total occlusion, 23 subtotal occlusion and 8 partial occlusion shown on initial angiograms. The incidence of re-opening was 17.1% (13/76) in less than 3 months, and 6.2% (6/97) between 3 and 6 months postoperatively. Four aneurysms showed recurrency(2.3%) on second follow-up angiography in one year after procedure and one-year cumulative recurrent rate was 13.3% of 56 aneurysms with the third follow-up angiography in the post-operation period of 12 to 54 months, four showed a little enlargement and the cmnulative recurrent rate so far was 20.2% (35/173). Conclusions The direct and main causes for aneurysmal recurrence are incomplete and loosening packing. The first angiographic follow-up is recommended to be performed at 3 months or earlier after the procedure, especially in aneurysms with initial incomplete occlusion. Re-treatment with balloon- or stent-assisted coil embolization is recommended in re-opening aneurysms.

关键词：脑动脉瘤血管栓塞神经介入学放射治疗

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