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논문 기본 정보

자료유형
학술저널
저자정보
Kim, Sung Jin (Department of Neurosurgery, Dankook University College of Medicine) Kim, Young-Joon (Department of Neurosurgery, Dankook University College of Medicine) Ko, Jung Ho (Department of Neurosurgery, Dankook University College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제5호
발행연도
2019.1
수록면
536 - 544 (9page)

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Objective : The objective of this study was to evaluatelong-term radiologic prognosis and characteristics of in-stent stenosis (ISS) after stent assisted coiling (SAC) for cerebral aneurysm and analyze its risk factors. Methods : Radiological records of 362 cases of SAC during 10 years were retrospectively reviewed. Patients were included in this study if they had follow-up angiogram using catheter selected angiography at least twice. All subjected were followed up from 12 months to over 30 months. Of 120 patients, 123 aneurysms were enrolled. Patient data including age, sex, aneurysm size, neck size, procedural complication, kinds of stent, ISS associated symptom, ruptured state, location of ISS, degree of ISS, radiologic prognosis of ISS, follow-up period of time, and medical comorbidities such as hypertension, diabetes mellitus (DM), dyslipidemia, and smoking were collected.Statistical comparisons of group clinical characteristics were conducted for the total population. Results : Among 123 casesof aneurysm, 22 cases (17.9%) of ISS were revealed on follow-up angiography. Multiple stenting was performed in three cases and intra-procedural rupture occurred in two cases. Most cases were asymptomatic and symptomatic stenosis was identified in only one case. Sixteen cases were ruptured aneurysm. Mild stenosis was observed in 11 cases. Moderate stenosis was found in eight cases and severe stenosis was identified in three cases. Mean timing of identification of ISS was 8.90 months. The most common type was proximal type. Most cases were improved or not changed on follow-up angiography. Only one case was aggravated from mild stenosis to occlusion of parent artery. Mean follow-up period was 44.3 months. We compared risk factors and characteristic between ISS group and non-ISS group using univariate analysis. Multiple stenting was performed for three cases (13.6%) of the ISS group and four cases (4.0%) of the non-ISS group, showing no statistical difference between the two groups (p=0.108). Additionally, the proportion of patients who had more than two risk factors among four medical risk factors (hypertension, DM, dyslipidemia, and smoking) was higher in the ISS group than that in the non-ISS group, the difference between the two was not statistically significant either (31.8% vs. 12.9%, p=0.05). Conclusion : Clinical course and long-term prognosis of ISS might be benign. Most cases of ISS could be improved or not aggravated. Control of medical co-morbidity might be important. To the best of our knowledge, our study had more cases with longer follow-up period of time than other reports.
#Intracranial aneurysm #Stents #Long term adverse effects #Risk factors

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참고문헌 (25)

참고문헌 신청
Akpek S / 2005 / Selfexpandable stent-assisted coiling of wide-necked intracranial aneurysms:a single-center experience / AJNR Am J Neuroradiol 26:1223~1231 google schola Banerjee C / 2017 / Stroke caused by atherosclerosis of the major intracranial arteries / Circ Res 120:502~513 google schola Behme D / 2015 / Lowprofile Visualized Intraluminal Support device (LVIS Jr) as a novel tool in the treatment of wide-necked intracranial aneurysms: initial experience in 32 cases / J Neurointerv Surg 7:281~285 google schola Biondi A / 2007 / Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms: strategies in stent deployment and midterm follow-up / Neurosurgery 61:460~468 google schola Cho YD / 2014 / Coil embolization of intracranial saccular aneurysms using the Low-profile Visualized Intraluminal Support(LVISTM™)device / Neuroradiology 56:543~551 google schola

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