文章摘要
陈如东，厉华，杨洪宽，曾令成，胡威，吴亚松，于加省.颅内动脉瘤支架辅助栓塞术后复发的危险因素[J].神经损伤功能重建,2025,(3):130-133
颅内动脉瘤支架辅助栓塞术后复发的危险因素
Risk Factors for Recurrence After Stent-Assisted Coiling of Intracranial Aneurysms
  
DOI：
中文关键词: 颅内动脉瘤  支架辅助栓塞  破裂动脉瘤  瘤颈  危险因素
英文关键词: intracranial aneurysms  stent-assisted coiling  ruptured aneurysms  neck  risk factors
基金项目:云南省科技厅重点 研发计划（云南省 “心脑同治”临床关 键新技术研发，No. 202203AC100007）； 国家自然科学基金 （基于 NF-κB 探讨 RAGE 在蛛网膜下 腔出血后早期脑损 伤中的双向作用机 制，No. 81601008）
作者单位
陈如东，厉华，杨洪宽，曾令成，胡威，吴亚松，于加省 华中科技大学同济 医学院附属同济医 院神经外科 
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中文摘要:
      目的：探求颅内动脉瘤（intracranial aneurysms，IAs）行支架辅助栓塞（Stent-assisted coiling，SAC）术后 复发的危险因素。方法：纳入2014年1月至2023年12月期间在我院接受SAC治疗并完成数字减影血管造 影（digital subtraction angiography，DSA）随访的446例患者，共486个动脉瘤。根据影像随访结果，486个动 脉瘤被分为复发组（n=38）和稳定组（n=448）。将人口学、临床、手术特征和形态学数据进行单因素Logistic 回归分析，然后使用逐步向前方法将单因素有意义的变量纳入多因素Logistic回归得到独立危险因素。并 使用受试者工作特征曲线评估独立危险因素的曲线下面积（area under the curve，AUC）。结果：瘤颈（P＜ 0.001，OR=1.287）、尺寸比（P＜0.001，OR=1.877）、Raymond分级Ⅱ级或Ⅲ级（P=0.034，OR=2.304）和破裂动 脉瘤（P=0.010，OR=3.058）是IAs行SAC治疗术后复发的独立危险因素。瘤颈、尺寸比、Raymond分级Ⅱ级 或Ⅲ级和破裂动脉瘤的AUC值分别为0.807、0.797、0.636和0.567。结论：瘤颈、尺寸比、Raymond分级Ⅱ级 或Ⅲ级和破裂动脉瘤是IAs行SAC治疗后复发的独立危险因素。
英文摘要:
      To investigate the risk factors for recurrence of intracranial aneurysms (IAs) after stent-assisted coiling (SAC). Methods: Total 446 patients with a total of 486 aneurysms who underwent SAC treatment and completed digital subtraction angiography (DSA) follow-up at our institution between January 2014 and December 2023 were enrolled. Based on imaging follow-up results, the aneurysms were categorized into a recurrence group (n=38) and a stable group (n=448). Demographic, clinical, surgical, and morphological characteristics were analyzed using Logistic regression. Variables with significance in univariate analysis were included in a multivariate Logistic regression using a stepwise forward method to identify independent risk factors. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was calculated to assess the predictive performance of the independent risk factors. Results: Independent risk factors for recurrence after SAC included neck (P<0.001, OR=1.287), size ratio (P<0.001, OR=1.877), Raymond scale II or III (P=0.034, OR=2.304), and Ruptured aneurysms (P=0.010, OR=3.058). The AUC values for neck size, size ratio, Raymond Class II or III, and ruptured aneurysms were 0.807, 0.797, 0.636, and 0.567, respectively. Conclusion: Neck, size ratio, Raymond grade II or III, and ruptured aneurysms are significant risk factors for recurrence following SAC of IAs.
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