显微外科夹持与血管内盘绕治疗眼动脉瘤视觉效果的比较。

IF 1.2 Q4 CLINICAL NEUROLOGY
Neurointervention Pub Date : 2022-03-01 Epub Date: 2022-01-20 DOI:10.5469/neuroint.2020.00185
Guangdong Lu, Jaewoo Chung, Jung Cheol Park, Jae Sung Ahn, Byung Duk Kwun, Deok Hee Lee
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引用次数: 1

摘要

目的:显微外科夹闭术和血管内盘绕术治疗眼动脉(OphA)内颈动脉瘤时,术后视力缺损是一个主要的问题。我们的目的是比较两种方式的安全性和有效性。材料和方法:我们回顾性分析并比较了2010年1月至2018年8月在我院行夹闭或卷绕治疗的眼动脉瘤的基线特征和术后视觉和血管造影结果。此外,通过球囊封堵试验评价封堵OphA的安全性。结果:本组56例动脉瘤采用夹持术,82例动脉瘤采用卷取术。不完全动脉瘤闭塞的即时和随访率在两组之间具有可比性(21.4% vs 22.0%;24.4% vs. 23.6%)。夹钳组治疗后视力缺陷发生率高于卷钳组(16.1% vs. 2.4%;P = 0.010)。在血管内盘绕术中,我们观察到6例患者的同侧眼球完全闭塞,3例患者的近侧眼球闭塞;然而,只有1例近OphA闭塞患者出现治疗后视野缺损。结论:血管内缠绕治疗的眼动脉瘤与显微手术夹持治疗的动脉瘤闭塞率相似,且术后视力缺陷较少。有充足支脉的眼静脉完全闭塞不引起治疗后的视力缺陷。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Visual Outcomes of Ophthalmic Artery Aneurysms Treated with Microsurgical Clipping and Endovascular Coiling.

Purpose: Post-treatment visual deficit is a major concern associated with both microsurgical clipping and endovascular coiling for the treatment of ophthalmic artery (OphA) aneurysms of the internal carotid artery. We aimed to compare the safety and effectiveness of the 2 modalities.

Materials and methods: We retrospectively reviewed and compared the baseline characteristics and postoperative visual and angiographic outcomes of OphA aneurysms treated by clipping or coiling between January 2010 and August 2018 at our hospital. In addition, the balloon occlusion test was performed to evaluate the safety of OphA occlusion.

Results: This study included 56 aneurysms treated by clipping and 82 aneurysms treated by coiling. Both the immediate and follow-up rates of incomplete aneurysm occlusion were comparable between the 2 groups (21.4% vs. 22.0%; 24.4% vs. 23.6%). The incidence of post-treatment visual deficits was higher in the clipping group than in the coiling group (16.1% vs. 2.4%; P=0.010). We observed total ipsilateral OphA occlusion in 6 patients and near occlusion in 3 patients during endovascular coiling; however, only 1 patient with near OphA occlusion showed a post-treatment visual field defect.

Conclusion: OphA aneurysms treated by endovascular coiling exhibited an aneurysm occlusion rate similar to that of microsurgical clipping with fewer post-treatment visual deficits. The total occlusion of OphA with adequate collaterals did not cause post-treatment visual deficits.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
34
审稿时长
12 weeks
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