Abstract：
OBJECTIVE: To evaluate the feasibility and durability of coil embolization for MCAB aneurysms by analyzing clinical and radiological results.
METHODS: From January of 2008 to June of 2018, we treated a total of 1785 aneurysms using coil embolization. The aneurysms were treated by both coiling and stent-assisted coiling. Among these cases, 223 MCAB aneurysms were analyzed retrospectively. Clinical and radiological assessments were conducted at admission, after treatment, at discharge, and at last clinical follow-up.
RESULTS: Coil embolization was performed on 223 MCAB aneurysms in 217 patients. Peri-procedural ischemic, hemorrhagic, and other complications within 30 days after coil embolization occurred at rates of 8.0 %, 8.0 %, and 2.0 %, respectively, in the ruptured group and at 2.9 %, 1.2 %, and 0 %, respectively, in the unruptured group. The overall morbidity and mortality rates associated with complications were 2.3 % and 2.0 %. The cumulative major recurrence rates were 5.1 % at 12 months, 7.1 % at 18 months, and 11.9 % at three years after coil embolization. The mean follow-up period was 33.27 ± 25.48 months. Independent risk factors for major recurrence after coil embolization for MCAB aneurysms were a ruptured aneurysm, initial incomplete occlusion, the aneurysm size, and the neck size.
CONCLUSIONS: Coil embolization is a good alternative treatment option for MCAB aneurysms compared to surgical clipping. Considering the risk factors for major recurrence, the follow-up angiography should continue up to three years after coil embolization.
METHODS: From January of 2008 to June of 2018, we treated a total of 1785 aneurysms using coil embolization. The aneurysms were treated by both coiling and stent-assisted coiling. Among these cases, 223 MCAB aneurysms were analyzed retrospectively. Clinical and radiological assessments were conducted at admission, after treatment, at discharge, and at last clinical follow-up.
RESULTS: Coil embolization was performed on 223 MCAB aneurysms in 217 patients. Peri-procedural ischemic, hemorrhagic, and other complications within 30 days after coil embolization occurred at rates of 8.0 %, 8.0 %, and 2.0 %, respectively, in the ruptured group and at 2.9 %, 1.2 %, and 0 %, respectively, in the unruptured group. The overall morbidity and mortality rates associated with complications were 2.3 % and 2.0 %. The cumulative major recurrence rates were 5.1 % at 12 months, 7.1 % at 18 months, and 11.9 % at three years after coil embolization. The mean follow-up period was 33.27 ± 25.48 months. Independent risk factors for major recurrence after coil embolization for MCAB aneurysms were a ruptured aneurysm, initial incomplete occlusion, the aneurysm size, and the neck size.
CONCLUSIONS: Coil embolization is a good alternative treatment option for MCAB aneurysms compared to surgical clipping. Considering the risk factors for major recurrence, the follow-up angiography should continue up to three years after coil embolization.
摘要：
目的：通过分析临床和放射学结果，评估线圈栓塞治疗MCAB动脉瘤的可行性和耐久性。
方法：从2008年1月至2018年6月，我们使用线圈栓塞治疗了总共1785个动脉瘤。动脉瘤通过卷绕和支架辅助卷绕治疗。在这些案例中,对223例MCAB动脉瘤进行回顾性分析。入院时进行临床和放射学评估，治疗后,在放电时，最后进行临床随访。
结果：对217例患者的223个MCAB动脉瘤进行了线圈栓塞。围手术期缺血，出血性,线圈栓塞后30天内的其他并发症发生率为8.0%，8.0%,和2.0%，分别,在破裂组和2.9%，1.2%,0%,分别,在未破裂组中。与并发症相关的总发病率和死亡率分别为2.3%和2.0%。12个月累积主要复发率为5.1%,18个月时为7.1%，线圈栓塞后三年为11.9%。平均随访时间为33.27±25.48个月。MCAB动脉瘤弹簧圈栓塞术后复发的独立危险因素是动脉瘤破裂,初始不完全遮挡,动脉瘤的大小,和脖子的大小。
结论：与手术夹闭相比，线圈栓塞是MCAB动脉瘤的良好替代治疗选择。考虑到严重复发的危险因素，血管造影随访应持续至线圈栓塞后3年.
方法：从2008年1月至2018年6月，我们使用线圈栓塞治疗了总共1785个动脉瘤。动脉瘤通过卷绕和支架辅助卷绕治疗。在这些案例中,对223例MCAB动脉瘤进行回顾性分析。入院时进行临床和放射学评估，治疗后,在放电时，最后进行临床随访。
结果：对217例患者的223个MCAB动脉瘤进行了线圈栓塞。围手术期缺血，出血性,线圈栓塞后30天内的其他并发症发生率为8.0%，8.0%,和2.0%，分别,在破裂组和2.9%，1.2%,0%,分别,在未破裂组中。与并发症相关的总发病率和死亡率分别为2.3%和2.0%。12个月累积主要复发率为5.1%,18个月时为7.1%，线圈栓塞后三年为11.9%。平均随访时间为33.27±25.48个月。MCAB动脉瘤弹簧圈栓塞术后复发的独立危险因素是动脉瘤破裂,初始不完全遮挡,动脉瘤的大小,和脖子的大小。
结论：与手术夹闭相比，线圈栓塞是MCAB动脉瘤的良好替代治疗选择。考虑到严重复发的危险因素，血管造影随访应持续至线圈栓塞后3年.
