Predictive value of cerebral aneurysm neck diameter on the occurrence of progressive cerebrovascular occlusion after stent-assisted coil embolization
10.3969/j.issn.1672-5921.2019.05.003
- Author:
Ma SU
1
Author Information
1. Department of Neurosurgery, Yulin First Hospital
- Publication Type:Journal Article
- Keywords:
Cerebral aneurysm;
Cerebral aneurysm neck diameter;
Progressive cerebrovascular occlusion;
Stent-assisted coil embolization
- From:
Chinese Journal of Cerebrovascular Diseases
2019;16(5):237-242
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the predictive factors of developing progressive cerebrovascular occlusion in incomplete occlusion after cerebral aneurysms treated with stent-assisted coil embolization. Methods: Ninety-two consecutive patients with cerebral aneurysm received stent-assisted coil embolization and immediate intraoperative angiography revealed incomplete occlusion at the Department of Neurosurgery, Yulin First Hospital from January 2012 to December 2015 were enrolled retrospectively. According to the follow-up results of angiography 6 months after operation, the patients were divided into progressive occlusion group (n = 59) and non-occlusion group (ra=33). Multi-dimensional angiographic images of patients immediately and 6 months after surgery were collected using a biplane angiography system and a threedimensional rotational angiography system, and the angiographic results of all patients were graded by the Raymond grading criteria. Predictors of progressive cerebrovascular occlusion were assessed using multivariate logistic regression analysis and receiver operating characteristic (ROC) curves. Results: The mean maximum diameter of cerebral aneurysms (6.6 ±2.9 mm) and mean neck diameter (4.9 ± 1.0mm) in the progressive occlusion group were less than those in the non-occlusion group (8.5 ±2.4 mm and 6. 2 ± 1. 2 mm respectively). The differences were statistically significant, (l = -3. 196 and -5.661 respectively,all P < 0.01). Multivariate logistic regression analysis showed that the neck diameter of cerebral aneurysms was an independent influencing factor for progressive cerebrovascular occlusion (OR,0. 44,95% CI 0. 18-0. 79, P =0.030). The cut-off value of neck diameter for predicting cerebrovascular occlusion was 5. 8 mm (specificity 82. 1%,sensitivity 75.8%,and the area under curve 0. 847,P <0. 01). Conclusions: The neck diameter of cerebral aneurysms was an independent predictor for progressive cerebrovascular occlusion after stent-assisted coil embolization. Patients with cerebral aneurysms < 5. 8 mm in neck diameter were more likely to spontaneously develop cerebrovascular occlusion within 6 months after stent-assisted coil embolization.
