后交通动脉瘤血管内治疗后不完全闭塞的定量数字减影血管造影分析及预测因素。

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Sheng-Qi Hu, Chun Zeng, Jinbiao Yao, Mirzat Turhon, Ting Liu, Wenqiang Li, Xinjian Yang
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引用次数: 0

摘要

目的:本研究旨在通过定量数字减影血管造影(QDSA)研究血管内治疗(EVT)后后交通动脉(PCoA)动脉瘤不完全闭塞的预测因素,探讨胎儿型大脑后动脉(fPCA)在闭塞结果中的作用。方法:我们对2016年至2022年接受EVT治疗的287例PCoA动脉瘤292例进行分析。根据随访DSA将动脉瘤分为不完全闭塞组(n = 49)和完全闭塞组(n = 243)。比较QDSA的临床、形态学和血流动力学参数,并通过多因素logistic回归确定独立危险因素。使用曲线下面积(AUC)和亚组分析评估预测性能,并对fPCA效应进行Benjamini-Hochberg校正。结论:大小、颈部CBF、单纯卷曲、破裂状态和fPCA是EVT治疗PCoA动脉瘤不完全闭塞的独立危险因素。fPCA可能通过血流动力学改变影响不完全闭塞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quantitative digital subtraction angiography analysis and predictive factors for incomplete occlusion in posterior communicating artery aneurysms after endovascular treatment.

Purpose: This study aimed to identify predictive factors for incomplete occlusion in posterior communicating artery (PCoA) aneurysms after endovascular treatment (EVT) and investigate the role of fetal-type posterior cerebral artery (fPCA) in occlusion outcomes using quantitative digital subtraction angiography (QDSA).

Methods: We analyzed 287 patients with 292 PCoA aneurysms treated with EVT between 2016 and 2022. Aneurysms were categorized into incomplete (n = 49) and complete (n = 243) occlusion groups based on follow-up DSA. Clinical, morphological, and hemodynamic parameters from QDSA were compared, and independent risk factors were identified via multivariate logistic regression. Predictive performance was evaluated using area under the curve (AUC) and subgroup analysis with Benjamini-Hochberg correction for fPCA effects.

Results: Independent risk factors for incomplete occlusion included size (p < 0.001, OR = 1.127), neck cerebral blood flow (CBF) (p = 0.001, OR = 4.024), simple coiling (p < 0.001, OR = 4.635), ruptured status (p = 0.002, OR = 3.281), and fPCA (p = 0.030, OR = 2.218). AUCs for the combined model, size, neck CBF, simple coiling, ruptured status, and fPCA were 0.822, 0.721, 0.708, 0.656, and 0.603, respectively. In the fPCA subgroup, ruptured status, neck CBF, neck cerebral blood volume (CBV), PCoA CBF, and PCoA CBV showed significance, while in the non-fPCA subgroup, only simple coiling and size remained significant.

Conclusion: Size, neck CBF, simple coiling, ruptured status, and fPCA are independent risk factors for incomplete occlusion in PCoA aneurysms treated with EVT. fPCA likely influences incomplete occlusion through hemodynamic changes.

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来源期刊
Neuroradiology
Neuroradiology 医学-核医学
CiteScore
5.30
自引率
3.60%
发文量
214
审稿时长
4-8 weeks
期刊介绍: Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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