The therapeutic effect of balloon-assisted coiling and stent-assisted coiling of ruptured intracranial aneurysms in the acute phase
10.3760/cma.j.issn.1671-0282.2018.12.004
- VernacularTitle:急性期球囊及支架辅助栓塞破裂型颅内动脉瘤
- Author:
He LIU
1
;
Bailong XIN
;
Tong LI
;
Hongliang ZHONG
;
Jianwen JIA
;
Yongquan SUN
;
Shubin GUO
Author Information
1. 首都医科大学附属北京朝阳医院神经介入科
- Keywords:
Acute phase;
Ruptured aneurysm;
Balloon-assisted coiling;
Stent-assisted coiling
- From:
Chinese Journal of Emergency Medicine
2018;27(12):1333-1336
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the perioperative complications and therapeutic effects of balloon-assisted coiling (BAC) and stent-assisted coiling (SAC) in patients with ruptured intracranial aneurysms in the acute phase. Methods Totally 91 patients with 91 intracranial ruptured aneurysms were treated with BAC or SAC in our hospital between January 2014 and December 2016. Among them, 37 patients were treated with BAC and 54 patients with SAC respectively. Of the two groups, the position distribution and shape of aneurysms, and the complications after procedures and the therapeutic effects were summarized and evaluated retrospectively using chi-square test. Results The width of the aneurysm neck was narrower in the BAC-treated group compared to the SAC-treated group (3.31±1.63 mm vs. 4.35±2.10 mm, P=0.01). The aneurysm body/neck ratio (B/N) was lower in the BAC-treated group than in the SAC-treated group (1.64 ± 0.46 vs. 1.35±0.66, P=0.025). The recurrence rate was higher in the BAC-treated group than that in the SAC-treated group (18.9％ vs. 0.9％, P=0.005). There was no statistical difference in perioperative complication in both the BAC-treated group and SAC-treated group. However, 2 patients died due to the relative postoperative intracranial bleeding in the SAC-treated group. Better outcomes (Modified Rankin Score, mRS, 0-2) were achieved in the BAC-treated group compared to the SAC-treated group (94.6％ vs. 88.9％, P=0.028) at the follow-up visit. Conclusions These findings suggested that there is no difference between the BAC-treated group and the SAC-treated group in the risk of complication. BAC can achieve a better prognosis,but it is more prone to relapse. The SAC method was more appropriate for wider neck aneurysms. It was also an option to coiling the aneurysm in BAC in acute phase firstly, followed by additional treatment in SAC during the follow-up period.
