[1]王涛,张昊,邢以嵩.颅内动脉瘤再次栓塞术后复发的影响因素分析[J].中国临床神经外科杂志,2023,28(10):621-624.[doi:10.13798/j.issn.1009-153X.2023.10.004]
　WANG Tao,ZHANG Hao,XING Yi Song.Risk factors for repeated recurrence of intracranial aneurysms treated with endovascular embolization[J].,2023,28(10):621-624.[doi:10.13798/j.issn.1009-153X.2023.10.004]
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颅内动脉瘤再次栓塞术后复发的影响因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
28
期数:
2023年10期
页码:
621-624
栏目:
论著
出版日期:
2023-10-31

文章信息/Info

Title:
Risk factors for repeated recurrence of intracranial aneurysms treated with endovascular embolization
文章编号:
1009-153X（2023）10-0621-04
作者:
王涛; 张昊; 邢以嵩
252000山东，聊城市第三人民医院神经外科（王涛、张昊、邢以嵩）
Author(s):
WANG Tao;  ZHANG Hao;  XING Yi Song
Department of Neurosurgery, The Third People's Hospital of Liaocheng, Liaocheng 252000, China
关键词:
颅内动脉瘤; 术后复发; 血管内栓塞; 再次复发; 危险因素
Keywords:
Intracranial aneurysm;  Repeated recurrence;  Re-embolization;  Risk factors
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2023.10.004
文献标志码:
A
摘要:
目的 探讨颅内动脉瘤再次栓塞术后复发的影响因素。方法 回顾性分析2018年7月至2022年7月再次栓塞治疗的86例初次栓塞术后复发的颅内动脉瘤的临床资料。再次栓塞术后DSA随访，若瘤体显影较前明显改变且清楚或合并破裂出血则为复发。采用多因素logistic回归模型分析再次复发的危险因素。结果 术后DSA随访显示，11例（12.79%）再次复发，75例未复发。多因素logistic回归分析显示，动脉瘤最长径≥10 mm、直接弹簧圈栓塞及术后即刻Raymond分级≥Ⅱ级为颅内动脉瘤再次复发的独立危险因素（P<0.05）。基于这些危险因素构建列线图，其C-index为0.708（95% CI 0.667~0.808），ROC曲线以评估列线图价值显示，曲线下面积为 0.711（95% CI 0.686~0.813），灵敏度为68.40%，特异度为83.00%。结论 颅内动脉瘤栓塞术后复发再次栓塞术后仍会复发。根据动脉瘤最长径、术后即刻Raymond分级及栓塞方式构建的列线图模型对预测再复发具有良好的价值。
Abstract:
Objective To investigate the risk factors for repeated recurrence of intracranial aneurysms treated with endovascular embolization. Methods The clinical data of 86 patients with intracranial aneurysms who underwent second endovascular embolization due to recurrence after first endovascular embolization from July 2018 to July 2022 were retrospectively analyzed. The reccurrence of aneurysms was diagnosed by DSA when the aneurysmal sac was significantly changed and clear than before or accompanied with bleeding. Multivariate logistic regression analysis was used to analysize the risk factors for recurrence after second endovascular embolization. Results According to the DSA, 11 patients (12.79%) relapsed and 75 did not. Multivariate logistic regression analysis showed that the long-diameter of aneurysms ≥10 mm, direct coil embolization and immediate Raymond grade ≥Ⅱ were independent risk factors for recurrence of intracranial aneurysms after second embolization (P<0.05). A nomogram was constructed based on the above risk factors, whose C-index was 0.708 (95%CI 0.667~0.808). ROC curve showed the area under the curve of the nomogram was 0.711 (95%CI 0.686~0.813), the sensitivity was 68.40%, and the specificity was 83.00%. Conclusions Recurrence of intracranial aneurysms after embolization can occur again after re-embolization. The nomogram model based on the long-diameter of aneurysms, Raymond grade immediately after embolization and embolization method has good value in predicting recurrence.

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备注/Memo

备注/Memo:
（2023-06-25收稿，2023-09-12修回）
更新日期/Last Update: 2023-10-31