医学
动脉瘤
栓塞
放射科
置信区间
优势比
高强度
栓塞
核医学
磁共振成像
外科
内科学
作者
Rikako Suzuki,Tomohiro Takigawa,Masaya Nagaishi,Akio Hyodo,Kensuke Suzuki
标识
DOI:10.1016/j.clineuro.2023.107699
摘要
Coil embolization is one of the main endovascular treatment for basilar apex aneurysms (BAAs), and thromboembolic events are important complications of coil embolization. Even in small aneurysms, there is a risk of rupture, and aggressive treatment should be considered for unruptured BAAs. Using diffusion-weighted imaging (DWI), the study aimed to investigate thromboembolic events after coil embolization for unruptured BAAs by focusing on the absolute aneurysm size and relative aneurysm size (size ratio [SR]).To evaluate the predictors of thromboembolic events, patients were divided into those with and without hyperintensity on DWI after coil embolization. Patient and radiographic characteristics were compared between the two groups. SR was defined as the maximum aneurysm diameter divided by the average parent artery diameter.Fifty-six unruptured BAAs in 56 patients were investigated. The mean aneurysm size and SR were 7.61 ± 2.18 mm and 2.74 ± 1.45, respectively. Postprocedural hyperintensity on DWI was detected in 17 patients (30.4%). SR was significantly larger in the group with hyperintensity on DWI (3.75 ± 1.97 vs. 2.3 ± 0.82, P < 0.01) in the univariate analysis. Multivariate analysis revealed that SR> 3.0 was a significant predictor of thromboembolic events after coil embolization for unruptured BAAs (odds ratio: 12.15; 95% confidence interval: 2.95-49.98; P < 0.01).This study showed that SR is a predictor of thromboembolic events after coil embolization for unruptured BAAs. Therefore, if even in small BAAs, if the BAAs dome height is large compared to the diameter of the posterior cerebral artery (e.g., there is a large SR), preoperative evaluation of the use of antiplatelet therapy is important, particularly to prevent thromboembolic events.
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