论文部分内容阅读
Objective: This study aimed to evaluate the clinical and angiographic outcomes of aneurysms that were completely or near-completely embolized and ascertain whether complete embolization is important in the stent-assisted coiling (SAC) of intracranial aneurysms.Methods: This retrospective study enrolled 390 patients (417 aneurysms).Among them,complete (100％) or nearcomplete (＞90％) angiographic obliteration of the aneurysms on immediate angiography was accomplished.Baseline characteristics,complications,angiography follow-up results,and clinical outcomes were analyzed.Results: Cumulative adverse events occurred in 30 patients (7.7％),including thromboembolic complications in 17 (4.4％),intraoperative rupture in 10 (2.6％),and others in 3 (0.8％).Statistical analyses revealed an increased intraprocedural rupture rate in the initial completely occluded aneurysms (5.6％ compared with 1.0％).The incidence of cumulative adverse events was higher in patients with completely occluded aneurysms (11.1％) than in those with near-completely occluded aneurysms (5.5％).Angiography follow-up was available for 173 aneurysms.Aneurysm occlusion status at follow-up was correlated with stent placement (p =0.000,odds ratio 5.847),size (p =0.000,odds ratio =6.446 for tiny aneurysms;and p =0.001,odds ratio =5.616 for small aneurysms),and initial aneurysm occlusion status (p =0.001,odds ratio =3.436).Complete occlusion at followup was seen in 82.6％ of the initial complete occlusion group versus 63.0％ of the initial near-complete occlusion group.The incidence of complete occlusion at follow-up was higher in the initial completely occluded aneurysms with SAC (100％) than in the initial completely occluded aneurysms with non-SAC (65.2％).Conclusions: Initial complete treatment may lead to higher complication rates and good clinical outcomes at follow-up.Stent placement may enhance progressive aneurysm occlusion.Initial complete occlusion with SAC can provide durable closure at follow-up.